超声测量宫颈长度和宫颈内口宽度在早产预测中的应用价值

目的探讨超声测量宫颈长度和宫颈内口宽度在早产预测中的应用价值。方法本研究于2010年3月～2012年3月对因有先兆早产征象的初产妇经阴道超声测量宫颈长度和宫颈内口宽度，并随访其妊娠结局，分析宫颈长度、宫颈内口宽度与早产的关系。结果108例产妇中早产32例，发生率为29．63％，将其列为早产组，其余76例产妇的先兆早产症状消失后出院。早产组产妇的宫颈长度较非早产组明显缩短（t=12．05，P〈0．05）；而早产组产妇的宫颈内口宽度则较非早产组明显延长（t=12．64，P〈0．05）；早产组产妇的宫颈Bishop评分明显高于非早产组（t=4．83，P〈0．05）。将108例初产妇按照其超声检查的宫颈长度分为≥30mm组、20-29mm组、10-19mm组、〈10mm组，并对各组之间早产发生率进行比较发现宫颈长度越短，早产发生率越高（X^2=18．67，P〈0．05）。将108初产妇按照其超声检查的宫颈内口宽度将其分为≥5mm组、〈5mm组，并对各组之间早产发生率进行比较发现宫颈内口宽度越宽，早产发生率越高（X^2=15．21，P〈0．05）。结论经阴道超声检测妊娠期宫颈变化是一种客观、有效、可重复的预测早产的方法。有望成为临床上预测早产的有效指标之一。

The predictive value of ultrasonographic measurement of cervical length and width in preterm delivery

Objective To investigate the predictive value of uhrasonographic measurement of cervical length and width in preterm delivery. Methods Threatened primipara was given transvaginal ultrasound measurement of cervical length and width within the cervix from March 2010 to March 2012, and followed-up of pregnancy outcome, and the rela- tionship between cervical length, cervical internal width and preterm birth were analyzed. Results Thirty-two cases in 108 cases of puerpera was premature delivery, and the incidence rate was 29.63% they were as the premature group. The remaining 76 cases of maternal with threatened preterm labor symptoms disappeared after discharged from hospi- tal. The cervical length of preterm group was significantly shorter than the non-preterm group （t = 12.05, P 〈 0.05）; and cervical internal width of the preterm group was significantly longer than the non-preterm group （t=12.64, P 〈 0.05）. The Bishop score of preterm group was significantly higher than that of non-preterm group （t=4.83, P 〈 0.05）. 108 primiparae was divided into ≥30 mm group, 20-29 mm group, 10-19 mm group, 〈10 mm group according to their ultrasonographic cervical length, and the incidence of preterm birth were compared between the groups found in the cervical length was shorter, the incidence of preterm birth was higher （X^2 = 18.67, P 〈 0.05）. 108 cases primiparae were divided into ≥ 5 mm group, 〈5 mm group according to the ultrasound examination of the cervix mouth width, and the incidence of preterm birth were compared between the groups found within the cervix mouth width was wider, the incidence of preterm birth was higher （X^2 = 15.21, P 〈 0.05）, Conclusion By transvaginal ultrasound detection of changes in the cervical pregnancy is an objective, effective, repeatable method for predicting preterm birth, and it is expected to become one of effective index prediction of preterm delivery in clinic.