[无症状双胎妊娠自发性早产的预防]
[Prevention of spontaneous preterm birth in asymptomatic twin pregnancies].
作者信息
Sentilhes L, Bouhours A-C, Bouet P-E, Boussion F, Biquard F, Gillard P, Descamps P
机构信息
CHU Angers, Service de gynécologie-obstétrique, 4, rue Larrey, 49033 Angers cedex, France.
出版信息
J Gynecol Obstet Biol Reprod (Paris). 2009 Dec;38(8 Suppl):S61-75. doi: 10.1016/S0368-2315(09)73562-8.
OBJECTIVES
To determine prenatal methods to predict and prevent spontaneous preterm birth in asymptomatic twin pregnancies.
METHODS
Articles were searched using PubMed, Embase and Cochrane library.
RESULTS
Uterine activity monitoring and bacterial vaginosis screening are not useful to predict preterm birth (EL2 and EL3 respectively). Current literature data are contradictory and insufficient to determine whether fetal fibronectin and digital cervical assessment are predictors of preterm birth. History of preterm birth (EL4), and cervical length measurement by transvaginal ultrasonography (EL2) predict preterm birth. Nevertheless, there are no intervention studies that have evaluated cervical length measurement in the prevention of preterm birth. Hospital bedrest, prophylactic tocolytic and progesterone therapy, and prophylactic cervical cerclage in patients with or without short cervix have not been shown to be effective in preventing preterm birth.
CONCLUSIONS
Prenatal methods to prevent spontaneous preterm birth in asymptomatic twin pregnancies are currently very limited.
目的
确定预测和预防无症状双胎妊娠自发性早产的产前方法。
方法
使用PubMed、Embase和Cochrane图书馆检索文章。
结果
子宫活动监测和细菌性阴道病筛查对预测早产无用（分别为EL2和EL3）。目前的文献数据相互矛盾，不足以确定胎儿纤连蛋白和阴道指诊是否为早产的预测指标。早产史（EL4）和经阴道超声测量宫颈长度（EL2）可预测早产。然而，尚无干预研究评估宫颈长度测量对预防早产的作用。对于有无宫颈短的患者，住院卧床休息、预防性宫缩抑制剂和孕激素治疗以及预防性宫颈环扎术均未显示出预防早产的有效性。
结论
目前，预防无症状双胎妊娠自发性早产的产前方法非常有限。
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