孕中早期经阴道超声两种方法测量宫颈长度对早产的预测价值比较

Comparison of predictive value of cervical length measured by two transvaginal ultrasonography methods for preterm birth in early stage of second trimester

  • 摘要:
    目的 比较孕中早期2种经阴道超声方法测量宫颈长度对早产的预测价值。
    方法 选取妊娠14~15周的产妇477例作为研究对象。采用三点法、两点法经阴道超声测量方法分别测量宫颈长度。根据其随访期间是否出现先兆早产症状及妊娠结局情况,将研究对象分为足月组、先兆早产组及早产组。分析妊娠结局与宫颈长度的相关性; 比较2种测量方法对早产的预测价值。
    结果 477例产妇中,早产51例,先兆早产136例,足月分娩290例。早产组的宫颈长度小于先兆早产组和足月组,先兆早产组的宫颈长度小于足月组,差异有统计学意义(P < 0.05)。同组产妇中,三点法测量的宫颈长度大于两点法,差异有统计学意义(P < 0.05)。三点法测量预测早产的特异度、准确率和阳性预测值高于两点法,假阳性率低于两点法,差异有统计学意义(P < 0.05); 三点法和两点法测量的灵敏度、阴性预测值比较,差异无统计学意义(P>0.05)。
    结论 孕中早期经阴道超声测量宫颈长度对早产具有较好的预测价值,三点法可提高测量宫颈长度的准确性。

     

    Abstract:
    Objective To compare the prediction value of cervical length measured by two transvaginal ultrasonography method for preterm birth in early stage of second trimester.
    Methods A total of 477 cases of pregnant women at 14 to 15 weeks of gestation were selected as the study objects. The cervical length was measured by transvaginal ultrasonography with three-point method and two-point method respectively. According to the symptoms of threatened preterm birth and pregnancy outcome during the follow-up period, the subjects were divided into full-term group, threatened preterm birth group and preterm birth group. The correlation between pregnancy outcome and cervical length was analyzed; the predictive value of the two measures for preterm birth was compared.
    Results Of the 477 parturients, 51 were preterm delivery, 136 were threatened preterm delivery, and 290 were full-term delivery. The cervical length of the preterm delivery group was significantly lower than that of the threatened preterm delivery group and the term preterm delivery group, and the cervical length of threatened preterm delivery group was significantly lower than that of full-term delivery group (P < 0.05). In the parturients of same group, the cervical length measured by three-point method was significantly greater than that by two-point method (P < 0.05). The specificity, accuracy and positive predictive value of three-point method were significantly higher than those of two-point method, and the false positive rate was significantly lower than that of two-point method (P < 0.05); there was no significant difference in sensitivity and negative predictive value between three-point method and two-point method (P>0.05).
    Conclusion The measurement of cervical length by transvaginal ultrasound in the middle and early pregnancy has a good predictive value for premature delivery, and the three-point method can improve the accuracy of cervical length measurement.

     

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