Norman Jane E
University of Glasgow, Division of Developmental Medicine, Glasgow Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, Scotland, UK.
Best Pract Res Clin Obstet Gynaecol. 2007 Oct;21(5):791-806. doi: 10.1016/j.bpobgyn.2007.03.002. Epub 2007 May 8.
The cervix maintains the fetus in situ during pregnancy and dilates during labour to allow delivery of the baby. Congenital or iatrogenically-induced structural abnormalities of the cervix are associated with an increased risk of preterm birth. The role of cervical infection is less clear. Cervical studies may be useful in the prediction of preterm delivery: both a shortened cervical length identified on transvaginal ultrasound examination and an increased level of fetal fibronectin in cervico-vaginal secretions are associated with an increased risk of preterm delivery. In singleton pregnancy, cervical cerclage reduces the risk of preterm birth by 25%. There is no evidence of a reduction in neonatal mortality or morbidity, and the beneficial effects of preterm birth reduction have to be set against the increased risk of maternal infection. Neither the American College of Obstetricians and Gynecologists (ACOG) nor the Royal College of Obstetricians and Gynaecologists (RCOG) has unequivocally endorsed cervical cerclage. Further work is required to define the role of the cervix in prediction and prevention of spontaneous preterm birth.
宫颈在孕期维持胎儿于原位，分娩时扩张以娩出胎儿。宫颈先天性或医源性结构异常与早产风险增加相关。宫颈感染的作用尚不清楚。宫颈相关研究可能有助于预测早产：经阴道超声检查发现宫颈长度缩短以及宫颈阴道分泌物中胎儿纤维连接蛋白水平升高均与早产风险增加相关。在单胎妊娠中，宫颈环扎术可将早产风险降低25%。尚无证据表明其能降低新生儿死亡率或发病率，且降低早产的有益效果必须与孕产妇感染风险增加相权衡。美国妇产科医师学会（ACOG）和英国皇家妇产科医师学院（RCOG）均未明确认可宫颈环扎术。需要进一步开展工作来明确宫颈在预测和预防自发性早产中的作用。
