Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York 10032, USA.
Am J Perinatol. 2010 Jan;27(1):37-40. doi: 10.1055/s-0029-1236437. Epub 2009 Aug 14.
We investigated whether the presence of symptoms predicts the timing of subsequent spontaneous preterm birth in a cohort of women with cervical length (CL) <1.5 cm. A retrospective cohort study was conducted that included patients from 23 to 28 weeks' gestation with a CL <1.5 cm on routine ultrasound. Two groups were defined on the basis of presenting symptoms at the time of the ultrasound examination: asymptomatic patients and those with symptoms of preterm labor. The incidence of delivery within 2 weeks was determined for both groups. A total of 88 patients with CL <1.5 cm were identified from an ultrasound database. There were 52 patients with CL <1.5 cm and no symptoms. Of these, 1 (1.9%) delivered within 2 weeks. The remaining 36 patients had a CL <1.5 cm and symptoms of preterm labor. Of these, 11 (30.6%) delivered within 2 weeks (relative risk 15.9, 95% confidence interval 2.1 to 118). Premature cervical shortening at 23 to 28 weeks, in the absence of symptoms of preterm labor, is rarely associated with preterm delivery within 2 weeks. Following those patients clinically may prevent prolonged hospitalization and allow steroid administration closer to the date of delivery.
我们研究了在 23 至 28 周有宫颈长度（CL）<1.5cm 的常规超声检查的妇女队列中，症状的出现是否预示着随后自发性早产的时间。进行了一项回顾性队列研究，纳入了在超声检查时无症状和有早产症状的患者。根据超声检查时的症状将两组定义：无症状患者和有早产症状的患者。两组的 2 周内分娩发生率均确定。从超声数据库中确定了 88 例 CL<1.5cm 的患者。其中 52 例 CL<1.5cm 且无症状。其中，1 例（1.9%）在 2 周内分娩。其余 36 例 CL<1.5cm 且有早产症状。其中，11 例（30.6%）在 2 周内分娩（相对风险 15.9，95%置信区间 2.1 至 118）。23 至 28 周时宫颈过早缩短，无早产症状，很少与 2 周内早产有关。对这些患者进行临床观察可能会防止长时间住院，并允许更接近分娩日期给予类固醇治疗。
