孕中期超声检测宫颈尺寸变化率及形态对早产的预测价值

Predictive value of cervical size change rate and morphology by ultrasound in the second trimester for premature delivery

目的探究孕中期超声检测宫颈尺寸变化率及形态对早产的预测价值。方法回顾性分析2021年7月至2022年7月萍乡市人民医院建档并分娩的80名孕中期孕妇的临床资料,根据妊娠结局是否发生早产分为对照组(未发生早产,n=69)与观察组(发生早产,n=11),均行经阴道超声检查。比较两组孕14、28周宫颈尺寸变化(宫颈长度、宫颈内口宽度)和宫颈长度缩短率、宫颈内口宽度增加率、孕28周宫颈形态,绘制ROC曲线分析宫颈长度缩短率、宫颈内口宽度增加率、宫颈形态对早产的预测价值。结果孕14周,两组宫颈长度、宫颈内口宽度比较差异无统计学意义;孕28周,观察组宫颈长度短于对照组,宫颈内口宽度大于对照组,差异有统计学意义(P<0.05);观察组宫颈长度缩短率、宫颈内口宽度增加率均高于对照组,差异有统计学意义(P<0.05)。孕28周,两组宫颈内口Y型、T型、V型占比比较差异无统计学意义;观察组U型占比为63.64%,高于对照组的27.54%,差异有统计学意义(P<0.05)。绘制ROC曲线分析结果显示,宫颈长度缩短率、宫颈内口宽度增加率、宫颈内口形态为U型预测早产的AUC分别为0.718、0.779、0.623,宫颈内口宽度增加率AUC最高。结论孕中期超声检测宫颈尺寸变化率、形态对早产具一定诊断价值。

Objective To explore the predictive value of cervical size change rate and morphology by ultrasound in the second trimester for pre-mature delivery.Methods The data of 80 pregnant women in the second trimester who delivered in Pingxiang People's Hospital from July 2021 to July 2022 were retrospectively analyzed,and they were divided into the control group(no premature delivery,n=69)and the observation group(pre-mature delivery,n=11)according to the pregnancy outcome,and all of them underwent transvaginal ultrasound examination.The changes of cervical size(cervical length,internal cervical orifice width)at 14 and 28 weeks of pregnancy and shortening rate of cervical length and the increasing rate of internal cervical orifice width,cervical morphology at 28 weeks of pregnancy were compared between the two groups,ROC curve was drawn to ana-lyze the predictive value of the shortening rate of cervical length,the increasing rate of cervical opening width in the second trimester for premature delivery.Results At 14 weeks of pregnancy,there was no significant difference in the cervical length and the internal cervical orifice width between the two groups;at 28 weeks of pregnancy,the cervical length in the observation group was shorter than that in the control group,and the internal cer-vical orifice width was larger than that in the control group,the differences were statistically significant(P<0.05);the shortening rate of cervical length and the increasing rate of internal cervical orifice width in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).At 28 weeks of pregnancy,there was no significant difference in the proportion of Y-type,T-type and V-type of cervical internal orifice between the two groups;the proportion of U-type in the observation group was 63.64%,which was higher than 27.54%in the control group,and the difference was statistically significant(P<0.05).ROC curve analysis showed that the AUC of the shortening rate of cervi-cal length,increasing rate of internal cervical orifice width,and U-type cervical orifice shape in predicting premature delivery were 0.718,0.779,and 0.623,respectively,and the AUC of increasing rate of internal cervical orifice width was the highest.Conclusion Ultrasound detection of cervical size change rate and morphology in the second trimester has certain diagnostic value for premature delivery.