经阴道超声测量子宫宫颈前角和宫颈长度对双胎早产的预测价值  

The Predictive Value of Anterior Uterocervical Angle and Cervix Length Measured by Transvaginal Ultrasound in Twin Preterm Delivery

作　　者：詹佐令 彭格红 ZHAN Zuoling;PENG Gehong(Department of Ultrasound,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China)

机构地区：[1]遵义医科大学附属医院超声科,遵义563000

出　　处：《宁夏医科大学学报》2023年第11期1137-1142,共6页Journal of Ningxia Medical University

摘　　要：目的探讨经阴道超声测量孕妇孕晚期子宫宫颈前角(ACA)和宫颈长度(CL)对预测双胎早产的价值。方法收集2019年12月至2021年12月遵义医科大学附属医院行产前超声宫颈检查双胎妊娠孕妇75例,年龄20~35岁,怀孕方式包括自然受孕与人工受孕,于孕晚期(孕28~32周)采用经阴道超声测量ACA及CL,记录测量结果。收集孕妇临床基本资料并追踪其妊娠结局。按照是否发生早产分为早产组及足月组,其中早产组32例(42.67%),足月组43例(57.33%)。比较两组ACA及CL,分析其对预测早产的价值及两者联合预测早产的临床价值。结果早产组ACA为(115.06±13.84)°、CL为(26.33±7.98)mm,足月组ACA为(92.90±12.89)°、CL为(33.68±5.61)mm,两组ACA、CL比较差异均有统计学意义(P均<0.05)。受试者工作特征(ROC)曲线显示,ACA及CL的线下面积分别为0.898、0.795,对应的最佳临界值分别为104.31°和28.35 mm,ACA预测早产的灵敏度及特异度分别为87.5%、88.4%,CL预测早产的灵敏度及特异度分别为71.9%、90.7%。ACA与CL联合的ROC曲线下面积为0.903,ACA与CL联合预测早产的灵敏度及特异度分别为87.5%、90.7%。结论经阴道超声测量孕晚期ACA及CL均是预测双胎早产的有效指标,ACA预测价值优于同期测量的CL,两者联合可以提高预测双胎早产的临床价值。Objective To investigate the value of transvaginal ultrasonography measuring anterior uterocervical angle(ACA)and cervical length(CL)in predicting premature delivery of twin pregnancies.Methods A total of 75 pregnant women aged 20-35 years who underwent prenatal ultrasound cervical examination for twin pregnancy at the Affiliated Hospital of Zunyi Medical University from December 2019 to December 2021 were collected.The pregnancy methods included natural conception and artificial insemination.ACA and CL were measured by transvaginal ultrasound in the third trimester(28-32 weeks of gestation),and the measurement results were recorded.The basic clinical data of pregnant women were collected and their pregnancy outcomes were tracked.According to the occurrence of preterm birth,they were divided into preterm birth group and full-term birth group.ACA and CL were compared between the two groups to analyze the value of ACA and CL in predicting preterm birth and the clinical value of the combination of ACA and CL in predicting preterm birth.Results Seventy-five twin-pregnancy women were included in this study,with 32 cases(42.67%)in the preterm group and 43 cases(57.33%)in the full-term group.ACA and CL in preterm delivery group were(115.06±13.84)°and(26.33±7.98)mm,while ACA and CL in term delivery group were(92.90±12.89)°and(33.68±5.61)mm.There were statistically significant differences in ACA and CL between the two groups(P all<0.05).ROC curve showed that the area below the line of ACA and CL were 0.898 and 0.795,respectively,corresponding to the optimal critical value of 104.31°and 28.35 mm,respectively.The sensitivity and specificity of ACA for predicting premature birth were 87.5%and 88.4%,respectively.The sensitivity and specificity of CL in predicting preterm birth were 71.9%and 90.7%,respectively.The area under ROC curve of ACA and CL combined was 0.903,and the sensitivity and specificity of ACA and CL combined in predicting preterm birth were 87.5%and 90.7%,respectively.Conclusion Both ACA and CL measured

关 键 词：经阴道超声检查 子宫宫颈前角 宫颈长度 双胎妊娠 早产 

分 类 号：R714.23[医药卫生—妇产科学]