中孕引产前经阴道超声测量宫颈长度的研究

目的评价中孕引产时宫颈长度与引产时间的关系。方法 163例孕14～26周妇女,采用依沙吖啶与米非司酮联合使用终止妊娠,在引产前进行经阴道超声检查,观察孕妇年龄、孕周、孕产次、宫颈长度以及引产时间。结果孕14～26周宫颈长度平均为(37.02±4.06)mm,且随孕周增加而有缩短趋势(r=-0.359,P﹤0.01)。宫颈长度与引产发动时间、产程时间及引产总时间显著相关,r分别为0.215、0.211及0.270,P均<0.01,宫颈长度是唯一影响引产发动时间、产程时间及引产总时间的变量。分析结果分别为R2=0.046,P<0.01,R2=0.044,P<0.01,R2=0.073,P<0.01,引产所需时间与孕产次、孕妇年龄及孕周无关。按宫颈长度分组,各组间引产发动时间(P<0.01)、产程时间(P<0.05)及引产总时间(P<0.01)均有统计学差异。结论引产前经阴道超声测量宫颈长度对引产时间有一定预测作用。

Transvaginal ultrasonographic measurement of the cervical length before termination of second trimester pregnancy

Objective To evaluate the relationship between cervical length and time of induced labor during termination of second trimester pregnancy.Methods One hundred and sixty-three women with 14-26 weeks of pregnancy underwent termination of pregnancy(TOP) by Ethacridine combined with Mifepristone.Transvaginal measurement was performed before the procedure,the maternal age,gestational age,gravida times,parity,cervical length and the time of induction delivery were observed.Results The overall mean cervical length was(37.02±4.06) mm at 14-26 weeks,cervical length decreased significantly with increasing gestational age(r=-0.359,P<0.01).Cervical length had significant correlation with the starting time of induced labor,time of labor stage and total time variable of induced labor,r=0.215,0.211 and 0.270 respectively,P<0.01.Cervical length was the only independent variable which affected the starting time of induced labor,time of labor stage and total time of induced labor.The analysis showed that R2=0.046,P<0.01,R2=0.044,P<0.01,R2=0.073,P<0.01.The time needed for induced labor was independent of gravida times,parity,maternal age and gestational age.When the subjects were divided five groups according to pre-induction cervical length,we found there were statistic difference in the starting time of induced labor(P<0.01),time of labor stage(P<0.05) and total time variable of induced labor(P<0.01).Conclusion The time of induction delivery can be predicted by transvaginal measurement of cervical length before second trimester termination of pregnancy.