摘要目的 观察经阴道超声监测宫颈长度预测双胎早产的效果。方法 随机选取2018年6月～2019年1月我院272例收治的双胎先兆早产孕妇，依据随机数字表法分为经阴道超声组（n=136）和经腹部超声组（n=136）两组，经阴道超声组孕妇接受经阴道超声监测，经腹部超声组孕妇接受经腹部超声监测，然后统计分析两组孕妇不同宫颈长度早产率、对双胎早产预测的价值。结果 经阴道超声组宫颈长度＜2.6 cm 孕妇早产率高于经腹部超声组，差异有统计学意义（P＜0.05）；宫颈长度≥2.6 cm 孕妇的早产率低于经腹部超声组，差异有统计学意义（P＜0.05）。经阴道超声组对双胎早产预测灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于经腹部超声组，差异有统计学意义（P＜0.05）。结论 经阴道超声监测宫颈长度预测双胎早产的效果较经腹部超声好。
Abstract：Objective To observe the effect of transvaginal ultrasound monitoring cervical length in predicting twin preterm birth.Methods A total of 272 cases of pregnant women with threatened preterm births from June 2018 to Jauary 2019 were randomly selected.They were divided into transvaginal ultrasound group (n=136) and transabdominal ultrasound group (n=136) according to the random number table method.Pregnant women in transvaginal ultrasound group were monitored by transvaginal ultrasound, and pregnant women in transabdominal ultrasound group were monitored by transabdominal ultrasound.Then the premature delivery rates of different cervical length in two groups of pregnant women and the values of predicting preterm births of twins were statistically analyzed.Results The premature delivery rate of pregnant women with cervical length ＜2.6 cm of the transvaginal ultrasound group was higher than that of transabdominal ultrasound group, the difference was statistically significant (P＜0.05), the premature delivery rate of the pregnant women with cervical length ≥2.6 cm was lower than that of transabdominal ultrasound group, the difference was statistically significant (P＜0.05).The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of transvaginal ultrasound group were higher than those of the transabdominal ultrasound group, the differences were statistically significant (P＜0.05).Conclusion The effect of transvaginal ultrasound monitoring cervical length is better than that of transabdominal ultrasound in predicting preterm births.
Romero R，Nicolaides KH，Conde-Agudelo A，et al.Vaginal progesterone decreases preterm birth ≤34 weeks of gestation in women with a singleton pregnancy and a short cervix：an updated meta-analysis including data from the OPPTIMUM study[J].Ultrasound Obstet Gynecol，2016，48（3）：308-317.
[18]
Melamed N，Pittini A，Hiersch L，et al.Do serial measurements of cervical length improve the prediction of preterm birth in asymptomatic women with twin gestations?[J].Am J Obstet Gynecol，2016，215（5）：616.
[19]
House M，Feltovich H，Hall TJ，et al.T hree-dimensional，extended field of view ultrasound method for estimating large strain mechanical properties of the cervix during pregnancy[J].Ultrason Imaging，2012，34（1）：1-14.
[20]
Conde-Agudelo A，Romero R，Da Fonseca E，et al.Vaginal progesterone is as effective as cervical cerclage to prevent preterm birth in women with a singleton gestation，previous spontaneous preterm birth，and a short cervix：updated indirect comparison meta-analysis[J].Am J Obstet Gynecol，2018，219（1）：10-25.
京公网安备 11010502046607号