阴道超声测量子宫颈长度及宫颈管宽度对预测早产的价值  

Study of the cervix of normal pregnancy and threatened preterm delivery using transvaginal sonography

作　　者：时春艳[1] 张云燕[1] 金燕志[1] 董悦[1] 

机构地区：[1]北京大学第一医院妇产科,100034

出　　处：《中华妇产科杂志》2003年第5期264-266,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　探讨阴道超声测量正常孕妇宫颈长度及宫颈管宽度对先兆早产孕妇发生早产的预测价值。方法　对无任何合并症和并发症的 1 54例正常单胎初产妇 ,于妊娠 1 6～ 35周经阴道超声测量宫颈长度和宫颈管宽度 ,记录宫颈内口有无开大。按孕周不同分成 5组 ,观察不同孕周组孕妇的宫颈变化。同时对 58例有先兆早产症状的孕妇进行宫颈长度及宫颈宽度的超声测量 ,并追踪其妊娠结局。结果　 (1 )正常单胎孕妇各不同孕周组间宫颈长度及宫颈管宽度无明显不同 ,宫颈长度平均为(36± 5)mm ,宫颈管宽度为 (4± 1 )mm ,均无宫颈内口开大。 (2 ) 58例先兆早产孕妇中发生早产的 1 1例为早产组 ,未发生早产的 47例为非早产组。两组孕妇年龄、孕次、出现先兆早产的孕周、保胎的方法及指检宫颈长度比较 ,差异均无显著性 (P >0 0 5)。以宫颈长度 > x - 2s(2 6mm)为界值 ,早产组孕妇的宫颈长度均≤ 2 6mm ,平均为 (1 8± 6)mm ,显著短于非早产组的 (32± 6)mm。两组比较 ,差异有极显著性 (P <0 0 0 1 )。 (3)以宫颈长度≤ 2 6mm为界值 ,预测先兆早产孕妇发生早产的敏感性为1 0 0 % ,特异性为 81 % ,阳性预测值为 55 % ,阴性预测值为 1 0 0 %。结论　经阴道超声检测宫颈长度 ,对先兆早产孕妇发生早产有一定的预测价值 。Objective To observe the changes of cervix in women between 16 and 35 weeks of gestation using transvaginal ultrasound and to determine the value of the cervix length in predicting preterm delivery among the women with threatened preterm labor Methods Transvaginal sonography were performed in 154 normal single nulliparous pregnant women between 16 and 35 weeks of gestation and 58 women with threatened preterm labor but without premature rupture of membrane Results (1) There is no definitely change in either cervical length or internal diameter of cervix among the pregnant women over the studied period There was also no funneling to be observed The mean cervical length is (36±5) mm,and the mean cervical internal diameter is (4±1) mm (2) Eleven preterm deliveries occured among the 58 pregnancy women with threatened preterm labor The cervical length by sonography of 11 preterm deliveries was (18±6) mm,and was significant shorter than the women without preterm deliveries whose mean cervical length was (32±6) mm ( P <0 001) The cervical length of women who delivered pretermly was totally ≤ 26 mm (3) A cervical length of 26 mm ( -2 s) as the cutoff to predict the preterm delivery among women with the threatened preterm labor has a 100% of sensitivity, 81% of specificity, 55% positive predictive value and a 100% of negative predictive value Conclusions Cervical length by transvaginal sonography can be used to predict preterm delivery among the women with threatened preterm labor Among women treated for preterm delivery, a cervical length of less than 26 mm indicated a high risk of preterm delivery, and intensive management is required

关 键 词：早产 阴道超声测量 子宫颈长度 宫颈管宽度 预测 

分 类 号：R714.21[医药卫生—妇产科学]