宫颈Bishop评分联合宫颈超声弹性成像及血清学标志物对宫颈成熟度评估价值的研究

Study on the Predictive Value of Cervical Ultrasound Elastography Combined with Serological Markers and Cervical Bishop Score for Cervical Ripening

目的:分析宫颈Bishop评分联合宫颈超声弹性成像技术及血清学标志物对宫颈成熟度的预测价值。方法:回顾2022年1—6月在北京大学第三医院产检分娩、需接受引产的孕妇178例,于引产前测定宫颈超声弹性成像指标、血清学标志物(松弛素、雌二醇、雌三醇、孕酮)、宫颈Bishop评分,根据最终分娩结局分为引产成功组158例和引产失败组20例。比较2组上述指标的差异,并利用受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)分析联合检测对宫颈成熟度评估的价值。结果:引产失败组弹性对比指数(elastic contrast index,ECI)、宫颈外口应变平均值(external cervical os,EOS)和松弛素水平低于引产成功组,宫颈长度长于引产成功组(P<0.05),2组间孕酮、雌二醇和雌三醇水平比较差异无统计学意义(均P>0.05)。宫颈Bishop评分联合超声弹性成像指标(ECI、EOS、宫颈长度)及血清松弛素时对宫颈成熟度的评估价值最高,ROC曲线下面积为0.940。结论:宫颈Bishop评分联合宫颈超声弹性成像和松弛素检查可提高预测宫颈成熟的准确性。

Objective:To analyze the predictive value of cervical Bishop score combined with cervical ultrasound elastography and serological markers for cervical ripening.Methods:178 pregnant women who were registered at Peking University Third Hospital from January 2022 to June 2022 and underwent induced labor were selected and divided into a successful labor induction group of 158 cases and a failed labor induction group of 20 cases.Cervical ultrasound elastography indexes,serological markers(relaxin,estradiol,estriol,progesterone),cervical Bishop score before induction of labor were collected and analyzed.Compare the differences in the above indicators between two groups,and use the receiver operator characteristic curve(ROC curve)to analyze the value of combined detection in evaluating cervical ripening.Results:The elastic contrast index(ECI),external cervical os(EOS)and relaxin levels of the failed labor induction group were lower than in the successful labor induction group,and the cervical length was longer than that in the successful labor induction group(P<0.05).There was no significant difference in the levels of progesterone,estradiol and estriol between the two groups(P>0.05).The combination of cervical Bishop score,ultrasound elastography indicators(ECI,EOS,cervical length),and serum relaxin had the highest evaluation value for cervical ripening,with an area under the ROC curve of 0.940.Conclusions:The cervical Bishop score combined with cervical ultrasound elastography and relaxin can improve the accuracy of predicting cervical ripening.