Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, 160012, India.
Arch Gynecol Obstet. 2009 Oct;280(4):565-72. doi: 10.1007/s00404-009-0957-8. Epub 2009 Feb 12.
To predict the risk of preterm birth (<37 weeks) or early preterm birth (<34 weeks) by cervicovaginal HCG and cervical length measured between 24-28 weeks of gestation in asymptomatic women at high risk for preterm birth.
This study was conducted in the departments' of Obstetrics & Gynaecology and Immunopathology of the Postgraduate Institute of Medical Education and Research, Chandigarh, India. In 75 pregnant women at high risk for preterm birth because of prior one on more preterm births due to spontaneous labour or ruptured membranes, cervicovaginal HCG and cervical length (by TVS) were measured between 24-28 weeks of gestation. These parameters were correlated individually and in combination for prediction of preterm birth.
Of the 75 women, 20 (26.7%) delivered <37 weeks and 6 (8%) delivered <34 weeks. To predict delivery <37 weeks, cervical length <2.95 cm had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 75%, 80.1%, 71.4% and 90.7% respectively, and cervicovaginal HCG >4.75 mIU/ml had a sensitivity, specificity, PPV, and NPV of 70%, 61.81%, 40% and 85% respectively. To predict delivery <34 weeks, cervical length <2.65 cm had a sensitivity, specificity, PPV, and NPV of 50%, 85.50%, 23.08% and 95.16% respectively; and cervicovaginal HCG >14 mIU/ml had a sensitivity, specificity, PPV and NPV of 83.3%, 85.5%, 33.3% and 98.3% respectively. Cervical length was superior to predict delivery <37 weeks, whereas HCG was superior to predict delivery <34 weeks. Their combination was superior to predict preterm birth both <37 weeks or <34 weeks, than either parameter used alone.
In high risk asymptomatic women, increased cervicovaginal HCG and reduced cervical length and between 24 to 28 weeks of gestation increased the risk of preterm delivery.
通过测量 24-28 孕周无症状的有早产高危因素的孕妇的宫颈阴道 hCG 和宫颈长度，预测早产（<37 周）或极早产（<34 周）的风险。
本研究在印度昌迪加尔的研究生医学教育和研究所妇产科和免疫病理学系进行。对 75 名因自发性早产或胎膜早破而有一次或多次早产史的有早产高危因素的孕妇，测量其 24-28 孕周时的宫颈阴道 hCG 和宫颈长度（经 TVS 测量）。单独和联合这些参数来预测早产。
75 名孕妇中，20 名（26.7%）分娩<37 周，6 名（8%）分娩<34 周。预测分娩<37 周时，宫颈长度<2.95cm 的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为 75%、80.1%、71.4%和 90.7%，宫颈阴道 hCG>4.75mIU/ml 的敏感性、特异性、PPV 和 NPV 分别为 70%、61.81%、40%和 85%。预测分娩<34 周时，宫颈长度<2.65cm 的敏感性、特异性、PPV 和 NPV 分别为 50%、85.50%、23.08%和 95.16%；宫颈阴道 hCG>14mIU/ml 的敏感性、特异性、PPV 和 NPV 分别为 83.3%、85.5%、33.3%和 98.3%。宫颈长度预测分娩<37 周的能力优于 hCG，而 hCG 预测分娩<34 周的能力优于宫颈长度。两者联合预测早产（<37 周或<34 周）的能力优于任何单一参数。
在无症状的高危孕妇中，24-28 孕周时宫颈阴道 hCG 增加、宫颈长度缩短增加了早产的风险。
