经阴道超声测量宫颈长度预测双胎妊娠预产期的价值研究  

Cervical length,twins pregnancy and prediction of preterm birth

作　　者：秦真英[1] 姜春峰[1] 孙明丽[1] 党金花[1] 杨文春 

机构地区：[1]山东省枣庄市立医院超声科,山东枣庄277100 [2]山东省枣庄市台儿庄区涧头医院,山东枣庄277100

出　　处：《医学影像学杂志》2007年第10期1081-1083,共3页Journal of Medical Imaging

摘　　要：目的：探讨应用经阴道超声测量宫颈长度，预测双胎妊娠预产期的价值。方法：对40例双胎妊娠中晚期（23—32周），自然分娩的孕妇，行阴道超声测量宫颈长度，记录受测孕妇的分娩孕周，选择适当的宫颈长度为界值，计算该界值预测双胎妊娠预产期的敏感性，特异性，阳性预期值和阴性预期值。结果：检测40例双胎孕妇宫颈长度为4．0±O．85cm（平均±标准差），6例宫颈长度〈3．5cm其中有5例（83％）在33孕周或之前分娩。34例宫颈长度≥3．5cm的孕妇，仅有2例（6％）在33孕周分娩。两组孕妇在33周或之前分娩的发生率有显著差异（P〈0．05）。宫颈长度〈3．5cm。预示在33周或之前分娩的敏感性，特异性，阳性预期值和阴性预期值分别为71％，94％，83％，94％。结论：胎儿出生之前，经阴道超声测量双胎孕妇的宫颈长度，可以提供有价值的预产期信息。减少新生儿并发症，降低新生儿死亡率，对确保妊娠的安全性具有重要的临床意义。Objective：To evaluate the application of transvaginal sonography assessment d cervical length before fetus production for predicting spontaneous preterm birth in twin gestation.Methods： The study cohort consisted of 40 women with twin gestation of spontaneous delivery. Cervical length was assessed via transvaginal sonography before fetal production, and data on pregnancy outcome were retrieved from maternal record and/or maternal interviews, and calculated the sensitivity, specificity, positive predictive value and negative predictive value of suitable cervical length.Results：Cervical length （mean± SD） of the 40 twins pregnancy at spontaneous delivery was 4.0±0 .85cm. Five of 6 （83 % ） women with a cervical length of 〈 3.5 cm delivered prior to 33 weeks gestation compared with 2/34 （6 % ） women with a cervical length ≥ 3.5 cm. This difference was statistically significant （ P 〈 0.05）. The sensitivity, specificity, positivepredictive value,and negative predictive value as cervical length 〈 3.5 cm to predict the delivery prior to 33 gestational weeks were 71%, 94%, 83 %, 94%, respectively. Conclusion： Transvaginal sonography to assess the cervical length in twin pregnancies before fetal production provides useful predictive information on the risk for preterm delivery.

关 键 词：宫颈长度 双胎妊娠 超声检查 

分 类 号：R714.23[医药卫生—妇产科学] R445.1[医药卫生—临床医学]