Tsoi E, Akmal S, Rane S, Otigbah C, Nicolaides K H
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
Ultrasound Obstet Gynecol. 2003 Jun;21(6):552-5. doi: 10.1002/uog.131.
More than 70% of women presenting with threatened preterm labor do not progress to active labor and delivery. The aim of this study was to investigate the hypothesis that in women with threatened preterm labor, sonographic measurement of cervical length helps distinguish between true and false labor.
We examined 216 women with singleton pregnancies presenting with regular and painful uterine contractions at 24-36 (mean, 32) weeks of gestation. Women in active labor, defined by the presence of cervical dilatation > or = 3 cm, and those with ruptured membranes were excluded. On admission to the hospital a transvaginal scan was performed to measure the cervical length. The subsequent management was determined by the attending obstetrician. The primary outcome was delivery within 7 days of presentation.
In 173 cases the cervical length was > or = 15 mm and only one of these women delivered within 7 days. In the 43 cases with cervical length < 15 mm delivery within 7 days of presentation occurred in 16 (37%) including 6/14 (42%) treated with tocolytics and 10/29 (35%) managed expectantly. Logistic regression analysis demonstrated that the only significant contributor in the prediction of delivery within 7 days was cervical length < 15 mm (odds ratio = 101, 95% CI 12-800, P < 0.0001) with no significant contribution from ethnic group, maternal age, gestational age, body mass index, parity, previous history of preterm delivery, cigarette smoking, contraction frequency or use of tocolytics.
In women with threatened preterm labor, sonographic measurement of cervical length helps distinguish between true and false labor.
超过70%出现先兆早产的女性不会进展为活跃产程并分娩。本研究的目的是调查这样一个假设，即在先兆早产的女性中，超声测量宫颈长度有助于区分真假分娩。
我们检查了216名单胎妊娠女性，她们在妊娠24 - 36周（平均32周）出现规律且伴有疼痛的子宫收缩。活跃产程（定义为宫颈扩张≥3 cm）的女性以及胎膜破裂的女性被排除。入院时进行经阴道扫描以测量宫颈长度。后续管理由主治产科医生决定。主要结局是就诊后7天内分娩。
173例患者宫颈长度≥15 mm，这些女性中只有1例在7天内分娩。在宫颈长度<15 mm的43例患者中，16例（37%）在就诊后7天内分娩，其中包括14例接受宫缩抑制剂治疗的患者中的6例（42%）以及29例期待治疗的患者中的10例（35%）。逻辑回归分析表明，预测7天内分娩的唯一显著因素是宫颈长度<15 mm（优势比 = 101，95%可信区间12 - 800，P < 0.0001），种族、产妇年龄、孕周、体重指数、产次、既往早产史、吸烟、宫缩频率或宫缩抑制剂的使用均无显著影响。
在先兆早产的女性中，超声测量宫颈长度有助于区分真假分娩。
