经阴道超声诊断孕妇宫颈机能不全及在预测胎儿早产中的价值

Transvaginal ultrasound diagnosis of cervical insufficiency in pregnant women and its prediction value for preterm birth

目的:探讨经阴道超声对妊娠中、晚期孕妇宫颈机能不全及预测胎儿早产的诊断价值。方法:选择宫颈机能不全的孕妇作为研究对象,分别在孕中期和孕晚期进行经阴道和经会阴超声检测宫颈长度。比较不同孕期、不同检测方法对宫颈机能不全的诊断效能,并分析其对胎儿早产的预测价值。结果:在孕晚期的宫颈长度显著低于孕中期(P<0. 05)。在孕中期和孕晚期,经阴道超声均有较高的敏感度,显著高于经会阴超声(P<0. 05)。经阴道超声的阴性预测值显著高于经会阴超声(P<0. 05)。在孕中期和孕晚期,宫颈长度<20 mm的早产率最高(P<0. 05)。在孕晚期检测宫颈长度为20~30 mm和<20 mm的早产率显著高于孕中期检测(P<0. 05)。结论:在孕中期和孕晚期经阴道超声检测宫颈长度对宫颈机能不全具有更高的敏感度和阴性预测值,并且在孕晚期通过经阴道超声对于早产具有更高的预测价值。

Objective:To investigate the diagnostic value of transvaginal ultrasound for cervical incompetence and premature delivery.Methods:Pregnant women with cervical insufficiency were selected as the study subjects,and the length of the cervix was detected by transvaginal and perineal ultrasound in the second trimester and the third trimester.To compare the diagnostic efficacy of different pregnancy methods and different detection methods for cervical insufficiency,and to analyze its predictive value for fetal preterm birth.Results:The length of the cervix in the third trimester was significantly lower than in the second trimester(P<0.05).In the second trimester and the third trimester,transvaginal ultrasound had higher sensitivity,which was significantly higher than that of perineal ultrasound(P<0.05).The negative predictive value of transvaginal ultrasound was significantly higher than that of perineal ultrasound(P<0.05).In the second trimester and third trimester,the preterm birth rate of cervical length<20 mm was the highest(P<0.05).Early detection of cervical length between 20 mm and 30 mm and<20 mm in the third trimester was significantly higher than that in the second trimester(P<0.05).Conclusion:Transvaginal ultrasound detection of cervical length in the second trimester and third trimester has a higher diagnostic efficacy for cervical insufficiency,and transvaginal ultrasound has the highest predictive value for preterm delivery in the third trimester.