经阴道超声对孕妇宫颈机能不全和胎儿早产的预测意义研究

The Predictive Significance of Transvaginal Ultrasound for Cervical Insufficiency in Pregnant Women and Premature Birth of Fetuses

目的探讨阴道超声在临床孕妇宫颈机能不全(CIC)与胎儿早产预测中的应用与效果。方法选取我院于2019年1月至2023年4月收治的86例疑似CIC患者作为本次研究观察对象,均给予其腹部超声(TAS)与经阴道超声(TVS)检查,根据随访结果对比分析两种检查方式在CIC病症诊断中的准确性,同时分析TVS在早产预测中的效果。结果86例疑似CIC患者经随访结果证实80例为CIC,其中,TVS检查诊断正确81例,诊断符合率为94.19%,高于TAS检查的81.40%(P<0.05)。且随孕周增加,CIC检出率也随之增加,且孕16~20周,和孕21~24周,TVS检出率高于TAS(均P<0.05)。TVS检查的宫颈显示满意度与羊膜囊突入率分别为100%与16.28%,高于TAS的76.74%与4.65%(均P<0.05)。86例孕妇中,32例发生早产,而足月孕妇宫颈长度长于早产孕妇(P<0.05)。TVS检查对宫颈长度低于20 mm的CIC患者早产预测准确率为100%。结论针对临床CIC患者,TVS检查准确率高,且能较好预测患者早产发生情况。

Objective To explore the application and effectiveness of vaginal ultrasound in predicting cervical insufficiency(CI)and premature birth in pregnant women.Methods A total of 86 suspected CIC patients who were treated in our hospital from January 2019 to April 2023 were selected as the target of this study observation,and the abdominal ultrasound(TAS)and vaginal ultrasound(TVS)were given.The accuracy of the examination method in the diagnosis of CIC symptoms,while analyzing the effect of TVS in premature prediction.Results A total of 86 suspected CIC patients were confirmed to have CIC through follow-up results.Among them,80 cases were diagnosed correctly by TVS examination,with a diagnostic accuracy rate of 94.19%,higher than 81.40%by TAS examination(both P<0.05).Moreover,as the gestational age increased,the detection rate of CIC also increased.Regardless of gestational age from 16 to 20 weeks or from 21 to 24 weeks,the detection rate of TVS was higher than that of TAS(both P<0.05).The satisfaction rate of cervical display and amniotic sac protrusion rate in TVS examination were 100%与and 16.28%,respectively,which were higher than the 76.74%and 4.65%of TAS(P<0.05).Meanwhile,among the 86 pregnant women,32 cases experienced premature birth,and the cervical length of full-term pregnant women was longer than that of premature birth pregnant women(P<0.05).And the accuracy of TVS examination in predicting premature birth in CIC patients with cervical length less than 20 mm is as high as 100%.Conclusions For clinical CIC patients,TVS examination has a high accuracy and can effectively predict the occurrence of premature birth.