经阴超声测量宫颈宽度与长度对产妇早产预测的临床应用分析

Clinical Application of Transvaginal Ultrasound to Measure the Width and Length of the Cervix for Predicting Maternal Preterm Birth

目的分析经阴道超声对宫颈宽度和长度对产妇早产的预测作用。方法收集该院2017年8月—2018年5月在该院住院的53例自发性早产高危孕产妇。记录所有孕妇的病历,并定期进行阴道超声检查以了解子宫颈的形状和长度。计算所有孕妇的妊娠结局。宫颈Bishop评分被用于评估孕妇宫颈成熟度以及经阴道超声检查测量的宫颈形状和长度与母亲早产的预后之间的关系。结果先兆早产组宫颈长度(20.36±9.12)mm短于非先兆早产组,宫颈内口宽度(11.24±3.65)mm明显长于非先兆早产组,Bishop评分(7.83±3.35)分高于非先兆早产组,差异有统计学意义(t=7.624、8.353、6.933,P<0.05)。随着宫颈长度的缩短,预测早产的特异性和阳性预测值将增加,宫颈长度≥25mm的敏感度将显着降低,而且宫颈长度<25mm的患者将具有明显的早产。与宫颈长度≥25mm的患者相比,差异有统计学意义(P<0.05);超声结果显示先兆早产组的内部宫颈宽度明显大于非先兆早产组(P<0.05)。53名孕妇中宫颈Bishop评分7~9分敏感度30.19%;宫颈长度<25mm敏感度22.64%;宫颈内口宽度≥5mm敏感度22.64%。比较3种方法对先兆早产预测敏感度差异无统计学意义(χ^2=1.685,P>0.05)。结论宫颈宽度和长度可以为早产危象提供客观有效的预测方法。经阴道超声检查在临床早产中的应用具有较高的预测价值。

Objective To analyze the predictive effect of transvaginal ultrasound on the width and length of the cervix on maternal preterm labor.Methods 53 high-risk pregnant women with spontaneous preterm birth were enrolled in this hospital from August 2017 to May 2018.Record the medical records of all pregnant women and perform regular transvaginal ultrasonography to understand the shape and length of the cervix.Calculate the pregnancy outcome of all pregnant women.Cervical Bishop scores were used to assess the relationship between cervical maturity in pregnant women and the shape and length of the cervix measured by transvaginal ultrasonography and the prognosis of maternal preterm birth.Results The length of cervical in the premature delivery group(20.36±9.12)mm was shorter than that in the non-premature delivery group.The width of the cervix(11.24±3.65)mm was significantly longer than that in the non-premature delivery group.The Bishop score(7.83±3.35)points in the premature delivery group was higher than that in the non-premature delivery group.The difference was statistically significant(t=7.624,8.353,6.933,P<0.05).As the length of the cervix shortens,the specificity and positive predictive value of predicting preterm birth will increase,the sensitivity of cervical length≥25 mm will be significantly reduced,and patients with cervical length<25 mm will have significant preterm birth.Compared with Patients with cervical length≥25 mm,the difference was statistically significant(P<0.05).Ultrasound results showed that the internal cervix width of the threatened preterm birth group was significantly greater than that of the no preterm birth group(P<0.05).Among the 53 pregnant women,the cervix Bishop score 7-9 points sensitivity 30.19%;the cervical length<25 mm sensitivity 22.64%;the cervical internal mouth width≥5 mm sensitivity 22.64%.There was no statistically significant difference in the sensitivity of the three methods for predicting preterm birth(χ^2=1.685,P>0.05).Conclusion Cervical width and length can provide objective and effective prediction methods for premature crisis.The application of transvaginal ultrasonography in clinical premature delivery has a high predictive value.