经阴道超声测量宫颈长度及子宫宫颈前角用于早产预测中的价值

The Value of Transvaginal Ultrasound Measurement of Cervical Length and Anterior Cervical Angle in Predicting Premature Delivery

目的:探讨经阴道超声测量宫颈长度(CL)、子宫宫颈前角(ACA)预测早产的价值。方法:对2022年1月~2023年8月在三明市大田县妇幼保健院分娩的80例门诊超声检查的正常孕妇与同期住院有先兆早产孕妇的病历资料进行回顾性分析,依据分娩结局分为足月产组和早产组,在孕16~24周产检时经阴道超声测量CL、ACA,对比两组CL、ACA,建立受试者工作特征(ROC)曲线,分析经阴道超声测量CL及ACA对早产的预测价值。结果:足月产组比早产组的CL更小,ACA更大,P<0.05;经ROC曲线分析,CL预测早产的AUC为0.799,敏感度为88.20%,特异度为69.60%,ACA预测早产的AUC为0.836,敏感度为91.20%,特异度为76.10%,两者联合预测早产的AUC为0.969,敏感度为100.00%,特异度为87.00%。与CL、ACA单独预测相比,联合预测价值更高。结论:经阴道超声测量CL及ACA对早产的预测敏感度、特异度均较高,且与CL相比,ACA对早产的预测价值相对更高。

Objective:Exploring the predictive value of transvaginal ultrasound measurement of cervical length(CL)and anterior cervical angle(ACA)for preterm birth.Methods:A retrospective analysis was conducted on the medical records of 80 normal pregnant women who underwent outpatient ultrasound examination and pregnant women with threatened preterm delivery who were hospitalized from January 2022 to August 2023 at Datian County Maternal and Child Health Hospital in Sanming City,according to the delivery outcome,the group was divided into a full term delivery group and a premature delivery group.CL and ACA were measured by vaginal ultrasound during the 16-24 weeks of pregnancy.CL and ACA were compared between the two groups,and a receiver operating characteristic(ROC)curve was established to analyze the predictive value of CL and ACA measured by vaginal ultrasound for premature delivery.Results:The CL of the full-term group was smaller and ACA was larger than that of the preterm group,P<0.05;After ROC curve analysis,the AUC predicted by CL for preterm delivery was 0.799,with a sensitivity of 88.20%and a specificity of 69.60%.ACA predicted AUC for preterm delivery was 0.836,with a sensitivity of 91.20%and a specificity of 76.10%.The combination of the two predicted AUC for preterm delivery was 0.969,with a sensitivity of 100.00%and a specificity of 87.00%.Compared with CL and ACA individual predictions,joint prediction has higher value.Conclusion:Transvaginal ultrasound measurement of CL and ACA has a higher sensitivity and specificity in predicting premature birth,and compared to CL,ACA has a relatively higher predictive value for premature birth.