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羊水指数在早产胎膜早破病例中的价值。

Values of amniotic fluid index in cases of preterm premature rupture of membranes.

机构信息

Department of Obstetrics and Gynecology, Lenox-Hill Hospital, New York, NY 10021, USA.

出版信息

J Perinat Med. 2009;37(3):232-5. doi: 10.1515/JPM.2009.078.

Abstract

AIMS

To measure the amniotic fluid index (AFI) in cases of preterm premature rupture of membranes (PPROM).

METHODS

A retrospective study of pregnancies complicated with PPROM was performed. Data collected included maternal age, parity, gestational age at PPROM and at birth, and AFI on admission. Gestational age matched AFIs were obtained from a low-risk control group in a 3:1 ratio.

RESULTS

One hundred and two singleton pregnancies with PPROM formed the study population. The mean gestational age at PPROM was 29+/-5.3 weeks (range: 14-36.6 weeks). The mean AFI in the PPROM and the control groups was 5.8+/-3.6 cm (0-18.5 cm) and 13.7+/-3.2 cm (7.3-24.4 cm), respectively (P<0.001). The area under the ROC curve of AFI in the prediction of PPROM was 0.95 (P<0.001). An AFI of < or =10 cm had sensitivity, specificity, positive and negative predictive values of 89.2%, 88.5%, 72.2% and 96%, respectively, in supporting the diagnosis of PPROM.

CONCLUSIONS

The presence of low AFI supports the diagnosis of PPROM. ROC curve analysis revealed that an AFI < or =10 cm is the optimal cut-off value in the suspicion of PPROM.

摘要

目的

测量早产胎膜早破(PPROM)病例的羊水指数(AFI)。

方法

对患有 PPROM 的妊娠进行回顾性研究。收集的数据包括母亲年龄、产次、PPROM 时和出生时的孕周以及入院时的 AFI。以 3:1 的比例从低危对照组中获得与胎龄匹配的 AFI。

结果

102 例单胎妊娠合并 PPROM 形成研究人群。PPROM 的平均胎龄为 29+/-5.3 周(范围:14-36.6 周)。PPROM 和对照组的平均 AFI 分别为 5.8+/-3.6 cm(0-18.5 cm)和 13.7+/-3.2 cm(7.3-24.4 cm)(P<0.001)。AFI 在预测 PPROM 中的 ROC 曲线下面积为 0.95(P<0.001)。AFI<或=10 cm 时,支持 PPROM 诊断的敏感度、特异度、阳性预测值和阴性预测值分别为 89.2%、88.5%、72.2%和 96%。

结论

低 AFI 支持 PPROM 的诊断。ROC 曲线分析显示,AFI<或=10 cm 是怀疑 PPROM 的最佳截断值。

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