经阴道超声评估宫颈成熟度对临产时间的预测价值研究  

Correlation study of cervix maturity by transvaginal ultrasonography in predicting time to labor

作　　者：董丽丽 王冰霜 李晓静[1] 乔轶男 李闯 许萍 齐铮琴[1] Dong Lili;Wang Bingshuang;Li Xiaojing;Qiao Yinan;Li Chuang;Xu Ping;Qi Zhengqin(Department of Ultrasound,the First Hospital of Qinhuangdao City,Hebei Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院超声科,河北秦皇岛066000

出　　处：《中国医刊》2023年第3期320-324,共5页Chinese Journal of Medicine

摘　　要：目的探讨经阴道超声评估宫颈成熟度对临产时间的预测价值。方法选取2020年9月至2021年11月在河北省秦皇岛市第一医院建档并分娩的孕妇46例,根据距离临产时间(time to onset of labor,TOL)分为TOL≤2周组15例、TOL>2周组31例,分别记录孕妇的一般资料、宫颈Bishop评分,经阴道超声宫颈内外口前后唇的弹性值、宫颈长度、宫颈宽度、胎头距会阴的距离。采用多因素logistic回归分析临产时间的影响因素,采用受试者工作特征曲线分析宫颈长度、宫颈内口前唇弹性值对临产时间的预测价值。结果两组孕妇年龄、孕周、宫颈Bishop评分、宫颈宽度、胎头距会阴的距离、宫颈内口后唇弹性值、宫颈外口前唇弹性值、宫颈外口后唇弹性值比较差异均无显著性(P>0.05)。TOL≤2周组宫颈长度、宫颈内口前唇弹性值显著低于TOL>2周组,差异有显著性(P<0.05)。多因素logistic回归分析结果显示,宫颈内口前唇弹性值及宫颈长度是临产时间的独立影响因素(P<0.05)。受试者工作特征曲线分析显示,宫颈长度、宫颈内口前唇弹性值预测2周内临产的最佳截断值分别为2.95cm、7.95kPa,宫颈长度、宫颈内口前唇弹性值以及两者联合预测临产时间的曲线下面积分别为0.717、0.792、0.869,敏感度分别为54.8%、67.7%、71.0%,特异度分别为80.0%、86.7%、93.3%。结论宫颈内口前唇弹性值可作为临产时间的预测指标,且与宫颈长度联合可提高预测临产时间的准确性,为产科医生提供指导。Objective To explore the predictive value of transvaginal ultrasound to assess cervical maturity on labor time.Method Fourtysix patients were divided into two groups according to the time to onset of labor(TOL):15 cases TOL≤2 weeks,31 cases TOL>2 weeks,record pregnant women’s general data,cervical Bishop score,cervical elasticity values,cervical length(CL),cervical width,fetal head distance from the perineum transvaginal ultrasound,and record the fetus double diameter,head circumference,vaginal delivery time,newborn weight.Logistic regression analysis was used to find out the index and then analyze the prediction value according to the ROC curve.Result The elasticity value of the anterior lip of the internal cervix and CL were independent influence factors(P<0.05).The prediction of the best diagnostic point of labor within 2 weeks of CL and the elasticity value of the anterior lip of the internal cervix was 2.95cm,7.95kPa.The sensitivity was 54.8%,67.7%and 71.0%,and the specificity was 80.0%,86.7%and 93.3%,respectively.Conclusion The elasticity value of the anterior lip of the internal cervix can be used as one of the indicators to predict the time of labor,and the combination with cervical length can improve the accuracy of predicting the time of labor,and provide favorable guidance for obstetricians to predict the time of labor in pregnant women.

关 键 词：经阴道超声 超声弹性成像 宫颈成熟度 临产时间 宫颈长度 宫颈BISHOP评分 

分 类 号：R445[医药卫生—影像医学与核医学]