子宫肌电图对先兆早产孕妇使用宫缩抑制剂后发生早产的预测  

Prediction of Preterm Labor Using Uterine Electromyography in Women with Threatened Preterm Labor after Tocolytic Therapy

作　　者：黄强 姜飞洲 侯文杰 何磊磊 于坤 陈丽 顾益惠 张靖童 张跃明 HUANG Qiang;JIANG Feizhou;HOU Wenjie(Department of Obstetrics and Gynecology,The Fourth Affiliated Hospital of Soochow University,Suzhou Jiangsu 215000,China)

机构地区：[1]苏州大学附属第四医院妇产科,江苏苏州215000

出　　处：《实用妇产科杂志》2025年第4期346-350,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨经腹子宫肌电图对先兆早产孕妇使用宫缩抑制剂后发生早产的预测。方法:选择苏州大学附属第四医院2023年1月至9月收治的孕28~34周先兆早产孕妇48例作为研究对象。根据使用宫缩抑制剂后的反应,是否延长妊娠至少48 h,分为48 h未早产组(35例)和48 h早产组(13例)。对两组宫缩抑制剂治疗前后肌电图数值的水平及差异进行比较,采用单因素Logistic回归分析子宫肌电图预测先兆早产孕妇使用宫缩抑制剂后48 h内发生早产的相关因素,并绘制受试者工作特征(ROC)曲线,评估其预测效能。结果:与使用宫缩抑制剂治疗前比较,治疗后48 h未早产组宫缩频率、宫缩面积、宫缩时间及宫缩幅度均显著降低,差异均有统计学意义(P<0.05);而治疗后48 h早产组仅宫缩频率降低,差异有统计学意义(P<0.05)。单因素Logistic回归分析示,宫缩频率、宫缩时间、宫缩面积均是预测先兆早产孕妇使用宫缩抑制剂后48 h内发生早产的相关因素(P<0.05)。当宫缩时间超过104.55 s,其预测48 h内发生早产的敏感度为92.3%,特异度为68.6%。结论:子宫肌电图对先兆早产孕妇使用宫缩抑制剂后48 h内发生早产的预测有一定价值,可能为后续的糖皮质激素治疗或高危孕妇的转运提供参考。Objective:To investigate the predictive value of transabdominal uterine electromyography for preterm labor after tocolysis in women with threatened preterm labor.Methods:A total of 48 pregnant women at 28-34 weeks of gestation diagnosed with threatened preterm labor and admitted to The Fourth Affiliated Hospital of Soochow University from January to September 2023 were included.According to the response to tocolysis and whether the pregnancy was prolonged for at least 48 h,women were divided into two groups:non-preterm birth within 48 h(n=35)and preterm birth within 48 h(n=13).Uterine electromyography parameters and difference were compared before and after tocolytic therapy in two groups.Univariate Logistic regression was performed to predict the related factors of preterm birth within 48 h after the using of tocolysis in pregnant women with threatened preterm birth by uterine electromyography,and receiver operating characteristic(ROC)curve was performed to evaluate their performance.Results:Compared to before treatment with tocolysis,after therapy,in the non-preterm birth within 48 h group,significant reductions in contraction frequency,area,duration and amplitude were observed(P<0.05).In the preterm birth within 48 h group,only contraction frequency decreased significantly(P<0.05).Univariate Logistic regression indicated that contraction frequency,contraction duration,and contraction area were predictive factors for premature birth within 48 h after tocolysis(P<0.05).When the duration of uterine contractions lasting for 104.55 s or more the sensitivity and specificity of predicting premature birth within 48 h are 92.3%and 68.6%,respectively.Conclusions:Uterine electromyography may predict the premature birth within 48 h after tocolytic treatment in preterm labor,which may provide reference for subsequent corticosteroid therapy or transfer of high-risk pregnant patients.

关 键 词：子宫肌电图 先兆早产 早产 宫缩抑制剂 

分 类 号：R714.21[医药卫生—妇产科学]