经阴道超声评估宫颈在预测早产中的临床价值

The Clinical Value of Transvaginal Ultrasound Evaluation of the Cervix in Predicting Preterm Birth

早产是全球5岁以下儿童死亡的主要原因,是全球健康领域的一个紧迫问题。目前,早产的防治仍是现代产科未解决的问题。早产是一种多因素疾病,其中宫颈异常是导致早产的一个重要因素。在妊娠期间,宫颈承担着双重角色,既是抵御微生物入侵的保护屏障,又是胎儿分娩过程中的结构屏障。经阴道超声(TVU)评估宫颈是早产预测的重要指标之一,特别是在曾经有过晚期流产史和(或)自发性早产史的孕妇中,为患者的诊断和治疗提供了实用而可靠的临床价值。在这篇综述中,我们概述了TVU评估宫颈在预测早产中的临床价值,单独使用宫颈长度(CL)、宫颈角度(UCA)、宫颈弹性成像等方式预测早产风险的特异性和敏感性低,可能会导致过度检查和过度治疗的发生,联合应用多种超声技术,可以充分发挥各项指标的优势,弥补单一技术所存在的局限性,从而大大提高早产预测的准确性。

Preterm birth is the main cause of death in children under 5 years old worldwide and an urgent is-sue in the global health sector. At present, the prevention and treatment of preterm birth is still an unresolved problem in modern obstetrics. Preterm birth is a multifactorial disease, among which cervical abnormality is an important factor leading to preterm birth. During pregnancy, the cervix plays a dual role as both a protective barrier against microbial invasion and a structural barrier during fetal delivery. Transvaginal ultrasound (TVU) evaluation of the cervix is one of the important indicators for predicting preterm birth, especially in pregnant women with a history of late miscar-riage and/or spontaneous preterm birth, providing practical and reliable clinical value for the di-agnosis and treatment of patients. In this review, we outline the clinical value of TVU in predicting preterm birth by evaluating the cervix. The use of methods such as cervical length (CL), uterocervi-cal angle (UCA), and cervical elastography alone has low specificity and sensitivity in predicting the risk of preterm birth, which may lead to over examination and over treatment. Combining multiple ultrasound techniques can fully leverage the advantages of various indicators and make up for the limitations of a single technique. This greatly improves the accuracy of preterm birth prediction.