经阴道超声监测孕妇宫颈形态预测早产的价值

目的评价经阴道超声监测宫颈形态变化对早产的预测价值。方法 223例孕妇分为足月分娩组134例和先兆早产组89例,分别于孕24、28、32及36周行经阴道超声检查,观察宫颈形态长度的变化,以及宫颈指数,并对其妊娠结局进行随访。结果足月分娩组中宫颈长度随孕周增大而缩短;先兆早产组孕妇的宫颈长度均较相应孕周的足月分娩组短,其中24、28及36周组间比较,差异有统计学意义(P<0.05)。先兆早产组各孕周的宫颈指数均较足月分娩组大,两组比较差异有统计学意义(P<0.05)。89例先兆早产组中71例保胎成功,18例发生早产。先兆早产组中21例有宫颈漏斗形成,18例早产者均有宫颈漏斗形成。漏斗形成预测早产的敏感性为100%、特异性为96.6%;以足月分娩孕妇28周时的宫颈长度2.61cm为临界值,其预测早产的敏感性为83.3%、特异性为100%。结论经阴道超声实时监测宫颈形态结构变化对预测早产的发生有一定的临床价值。

Value of transvaginal ultrasound in monitoring uterine cervix for predicting preterm delivery

Objective To evaluate the value of transvaginal ultrasound in monitoring uterine cervix for predicting preterm delivery. Methods A total of 223 pregnant women including 134 cases of term birth, 89 cases of threatened premature delivery pregnancy were examined by transvaginal ultrasound at 24, 28, 32 and 36 week＇s gestation. The change of uterine cervix morphology was observed, and the pregnant ending was followed up. Results The cervical length in term birth women was decreased with the increase of pregnant week, the cervical length in threatened premature delivery pregnancy women was decreased than that in term birth women, and there was significant difference at 24 weeks, 28 weeks and 36weeks （ P 〈 0.05 ）. The cervical index in threatened premature delivery pregnancy women was higher than that in term birth women, there was significant difference between two groups （P 〈 0.05 ）. In 89 premature delivery pregnancy women, 18 cases with premature delivery had funneling presence, the sensitivity and specificity were 100% and 96.6%, respectively. Regarding the cervical length of 2.61 cm in term birth women as critical value at 28 weeks, the sensitivity and specificity were 83.3% and 100% , respectively. Conclusion Transvaginal uhrasonography has important clinical value in monitoring the morphology changes of uterine cervix for predicting preterm delivery.