经阴道超声测量与细胞因子预测宫颈成熟度及足月分娩发动时间的对比研究

[Comparison study on transvaginal ultrasonographic measurement and cytokine in prediction of the cervical ripening and the onset time of term labor].

作者信息

Jian Li, Mu Xiaoling, Wu Weixin

机构信息

Department of Obstetrics and Gynecology, First Affiliated Hospital, Chongqing University of Medical Sciences, Chongqing 400016, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2002 Dec;37(12):708-11.

PMID:12622909

Abstract

OBJECTIVE

To compare the level of interleukin-6 (IL-6), interleukin-8 (IL-8), human chorionic gonadotropin (hCG) with transvaginal ultrasonographic measurement in prediction of the cervix ripening and the time of term labor.

METHODS

The 79 cases of primiparous women of term pregnancy were chosen as the research subjects. The maternal level of IL-6, IL-8, hCG in cervicovaginal secretions were measured. The cervical length, internal cervical os wedge width and forebag length were measured by transvaginal ultrasonography. The cervical Bishop score was also determined.

RESULTS

(1) The levels of IL-6, IL-8, hCG in cervicovaginal secretions were significantly higher in women they are in labor than that of women at term not in labor (782 +/- 508) ng/L, (10,539 +/- 8 680) ng/L, (114 +/- 86) IU/L, versus (155 +/- 75) ng/L, (7,113 +/- 6 050) ng/L, (35 +/- 21) IU/L, respectively. (2) The levels of cervicovaginal secretions IL-6, IL-8, hCG and the length of cervical, forebag were significant correlation with the cervical Bishop score (P < 0.05, r = 0.42, 0.24, 0.44, -0.56, 0.35) respectively. (3) The levels of cervicovaginal secretions IL-6, IL-8, the length of cervical, forebag measured by transvaginal ultrasonography and the cervical Bishop score were significant correlation to the onset time of term labor (P < 0.01, r = -0.42, -0.46, 0.64, -0.52, -0.41) respectively, and all these markers also could predict the onset of term labor in < or = 7 days, The predictive value on onset labor within < or = 7 days by cervical length < or = 30 mm: the sensitivity, specificity, positive values and negative value are 0.83, 0.89, 0.91 and 0.81 respectively. (4) Among the several markers in predicting cervix ripening and onset of labor, the best one was the transvaginal ultrasonographic measurement of cervical length.

CONCLUSIONS

The levels of cervicovaginal secretions IL-6, IL-8, the length of cervical and forebag measured by transvaginal ultrasonography and the Bishop score are valuable in prediction of cervix ripening and onset of labor. The cervical length measured by transvaginal ultrasonography is the best one.

摘要

目的

比较白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、人绒毛膜促性腺激素（hCG）水平与经阴道超声测量在预测宫颈成熟度和足月分娩时间方面的作用。

方法

选取79例足月妊娠初产妇作为研究对象。检测宫颈阴道分泌物中母体IL-6、IL-8、hCG水平。经阴道超声测量宫颈长度、宫颈内口楔形宽度和前羊膜囊长度。同时确定宫颈Bishop评分。

结果

（1）临产妇女宫颈阴道分泌物中IL-6、IL-8、hCG水平显著高于未临产足月妊娠妇女，分别为（782±508）ng/L、（10539±8680）ng/L、（114±86）IU/L，而未临产者分别为（155±75）ng/L、（7113±6050）ng/L、（35±21）IU/L。（2）宫颈阴道分泌物IL-6、IL-8、hCG水平及宫颈长度、前羊膜囊长度与宫颈Bishop评分均呈显著相关（P<0.05，r分别为0.42、0.24、0.44、-0.56、0.35）。（3）宫颈阴道分泌物IL-6、IL-8水平、经阴道超声测量的宫颈长度、前羊膜囊长度及宫颈Bishop评分与足月分娩发动时间均呈显著相关（P<0.01，r分别为-0.42、-0.46、0.64、-0.52、-0.41），且这些指标均能预测在≤7天内发动分娩，宫颈长度≤30mm对≤7天内发动分娩的预测价值：敏感度、特异度、阳性预测值和阴性预测值分别为0.83、0.89、0.91和0.81。（4）在预测宫颈成熟度和分娩发动的几个指标中，经阴道超声测量宫颈长度是最佳指标。