经阴道超声E-cervix技术对中孕期妇女自发性早产的预测价值

Predictive Value of Transvaginal Ultrasound E-cervix Technique for Spontaneous Preterm Birth in Midterm Pregnancy

目的探讨应用经阴道超声宫颈弹性成像(E-Cervix)技术预测中孕期妇女自发性早产的价值。方法选取2022年1月至2023年3月在江西省妇幼保健院进行产检的225例孕产妇为研究对象。根据是否孕足月将其划分为早产组(n=105)和足月产组(n=120),回顾性分析2组临床资料和超声检查参数[宫颈长度(CL)、宫颈弹性成像]。运用多元逻辑回归分析影响自发性早产发生的相关因素,应用受试者工作特征曲线(ROC)评估妊娠中期CL及宫颈弹性值预测自发性早产的效能。结果双胎(Z=9.909,P=0.002)和宫颈机能不全(Z=14.189,P<0.001)是早产的危险因素。妊娠中期CL越短(t=2.312,P=0.022),硬度比值(t=6.189,P<0.001)越小,弹性对比指数(t=-3.002,P=0.003)、宫颈内口(t=-4.890,P<0.001)应变值、宫颈外口应变值(t=-5.787,P<0.001)越大,早产发生的风险越高。ROC分析结果显示,宫颈内口应变值(AUC=0.689)、宫颈外口应变值(AUC=0.612)、弹性对比指数(AUC=0.718),各指标联合诊断较单一指标具有更高的预测早产的价值(AUC=0.764)。结论应用E-Cervix技术能够有效地预测中孕期孕妇自发性早产的可能性。

Objective To investigate the value of applying transvaginal ultrasound cervical elastography(E-Cervix)for the prediction of spontaneous preterm birth in midtrimester women.Methods 225 pregnant women,who underwent obstetric examination in Jiangxi Maternal and Child Health Hospital from January 2022 to March 2023,were selected for the study.They were divided into preterm group(n=105)and full-term group(n=120)based on their fertility conditions.The clinical data and ultrasonographic parameters(cervical length(CL),cervical elastography)of the 2 groups were retrospectively analyzed.Multiple logistic regression was used to analyze related factors affecting spontaneous preterm birth,and the receiver-operating characteristic curve(ROC)was applied to assess the efficacy of mid-gestational CL and cervical elasticity values in predicting spontaneous preterm birth.Results Twin pregnancy(Z=9.909,P=0.002)and cervical insufficiency(Z=14.189,P<0.001)were risk factors for preterm birth.The shorter the CL in midterm pregnancy(t=2.312,P=0.022),the smaller the durometer ratio(t=6.189,P<0.001),and the greater the elasticity contrast index(t=-3.002,P=0.003),endocervical(t=-4.890,P<0.001)strain value and ectocervical strain value(t=-5.787,P<0.001),the higher the risk of preterm labor might become.ROC analysis suggested that the endocervical strain value(AUC=0.689),the ectocervical strain value(AUC=0.612),and the elasticity contrast index(AUC=0.718),and the combination of these indicators had a higher diagnostic value in predicting preterm birth than a single indicator(AUC=0.764).Conclusion The E-Cervix technique could be effective in predicting spontaneous preterm birth in midterm pregnancy.