经会阴超声测量中孕期宫颈管长度在预测先兆早产中的临床应用

Clinical Application of Measurement of Mid Pregnancy Cervical Canal Length by Transperineal Ultrasound in Prediction of Threatened Preterm Birth

目的:为了更好地指导临床对先兆早产的干预和治疗,探讨经会阴超声测量中孕期宫颈管长度应用价值和意义。方法:选取在本院住院治疗的孕妇(伴自发性早产高危因素)70例为研究对象,均经会阴超声测量中孕期宫颈管长度和内口宽度。对于有先兆早产迹象的孕妇同时给予醋酸阿托西班治疗,观察并统计先兆早产情况,将其纳入先兆早产组,其他为非先兆早产组,比较两组宫颈长度、宫颈内口宽度,比较不同宫颈长度、宫颈内口宽度孕妇的先兆早产发生情况。结果:本研究中先兆早产21例、非先兆早产49例;与非先兆早产组比较,先兆早产组宫颈长度明显缩短,宫颈内口宽度则明显增加,差异均有统计学意义(P<0.05);70例孕妇根据宫颈长度分为<9、10~19、20~24、≥25 mm四组,先兆早产发生率分别为70.00%(7/10)、25.00%(3/12)、30.00%(6/20)、17.86%(5/28),宫颈长度<9 mm组先兆早产发生率明显高于其他三组(P<0.05);70例孕妇根据宫颈内口宽度分为<5、≥5 mm两组,先兆早产发生率分别为13.33%(6/45)、60.00%(15/25),宫颈内口宽度≥5 mm组先兆早产发生率明显高于<5 mm组(P<0.05)。结论:经会阴超声测量中孕期宫颈长度及形态,有助于客观、准确、有效的预测先兆早产发生,操作简单方便,安全性高,值得临床应用。

Objective:In order to better guide the clinical intervention and treatment of threatened preterm birth,to explore the application value and significance of the length of cervical canal during pregnancy measured by transperineal ultrasound.Method:Seventy pregnant women (with high risk factors of spontaneous premature delivery) in our hospital were selected as the research objects.The cervical canal length and inner mouth width were measured by transperineal ultrasound.At the same time,the pregnant women with signs of preterm delivery were treated with Atosiban Acetate.The condition of threatened preterm birth were observed and included in the threatened preterm birth group,the others were non threatened preterm birth group,the cervical canal length and inner mouth width in two groups were compared,the incidence of threatened preterm birth of pregnant women with different cervical canal length and inner mouth width were compared.Result:In this study,21 cases of threatened preterm birth and 49 cases of non threatened preterm birth were included.Compared with the non threatened preterm birth group,the cervical canal length in the threatened preterm birth group was significantly shortened,while the inner mouth width was significantly increased,the differences were statistically significant (P<0.05).According to the cervical canal length,70 pregnant women were divided into <9,10-19,20-24 and ≥25 mm groups,the incidence of threatened preterm birth were 70.00% (7/10),25.00% (3/12),30.00% (6/20) and 17.86% (5/28),respectively.The incidence of threatened preterm birth in the group with cervical length <9 mm was significantly higher than that in the other three groups (P<0.05).According to the inner mouth width,70 pregnant women were divided into <5 and ≥5 mm groups,the incidence of threatened preterm birth were 13.33% (6/45) and 60.00% (15/25),respectively.The incidence of threatened preterm birth in the inner mouth width ≥5 mm group was significantly higher than that in the inner mouth width <5 mm group (P<0.05).Conclusion:The measurement of cervical canal length and shape during pregnancy by transperineal ultrasound is helpful to predict the occurrence of threatened preterm birth,accurately and effectively.It is simple and convenient to operate,and has high safety.It is worthy of clinical application.