经会阴超声测量宫颈长度预测早产风险

目的探讨经会阴超声测量宫颈长度对早产的预测价值。方法选择2012年1月至2012年12月在北海市人民医院门诊就诊或住院的孕28’～36’周正常产查孕妇60例、先兆早产孕妇45例，经会阴超声测量宫颈长度并追踪妊娠结局，分析宫颈长度与妊娠结局的关系。结果0）60例正常产查孕妇正常分娩（正常顺产组），45侧先兆早产孕妇13例早产（早产组），32例足月分娩（先兆早产组）。正常顺产组、早产组宫颈长度平均值与先兆早产组比较差异有统计学意义（P〈0．01）。②按宫颈长度≤20、≤25、≤30、≤35mm预测早产的灵敏度、特异度、阳性预测值及阴性预测值，发现宫颈越短，预测早产的特异度越高，而灵敏度越低；宫颈长度≤30mm时发生早产的灵敏度及特异度之和为最大值，此时阳性预测值为52％、阴性预测值为95％。③先兆早产孕妇宫颈长度≤30mm及〉30mm早产的发生率分别为52．2％及4．5％，两者对比差异有统计学意义（P〈0．01）。结论经会阴超声测量宫颈长度对早产的预测有一定的临床价值，先兆早产孕妇宫颈长度≤30mm时，早产发生率较高，可作为预防早产的警戒线。

Prediction of the Risks of Premature Labor by Cervical Length through Perineum Ultrasonic Meas- urement

Objective To explore the prediction value for premature birth by cervical length （CL） through perineum ultrasonic measurement. Methods The pregnancy outcomes of 28 % -36% weeks natural labor pregnant women in 60 cases and premature pregnant women in 45 cases, who visited People＇s Hospital of Beihai City,from Jan. to Dec. in 2012 were tracked by CL through perineum ultrasonic measurement. Results @Among the 60 cases with normal labor check pregnant woman normal delivery （ called normal natural labor group）, 13 cases premature labor（ called premature labor group）and 32 cases with mature delivery （called omen preterm group）in 45 cases with preterm labor sign in pregnant women, the differences of the average cervical length of normal natural labor group and the premature labor group compared with omen preterm group were statistically significant （ P 〈 0.01 ）. @As for the sensitivity, specificity, positive pre- dictive value and negative predictive value of the cervical length≤20 mm, ≤25 mm, ≤30 mm, ≤35 mm to predict premature labor, it showed that the shorter the cervix, the higher the predictive specificity and the lower the sensitivity. It reached to the maximum value of the sensitivity and specificity of preterm birth at the cervical length ≤30 mm. At this point, the positive predictive value was 52%, while the negative predictive value was 95%. @The preterm delivery rates were 52.2% and 4.5% of the pregnant women with preterm labor cervical length ≤ 30 mm and 〉 30 mm, the difference was of statistical significance （P 〈 0.01 ）. Conclusion Measuring CL through perineum ultrasonic measurement has a certain clinical value to predict premature labor. When the CL is≤30 mm in the pregnant women with threatened preterm delivery, the pre- term birth rate is high,which can be used as the warning line of prevention.