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[经阴道超声测量子宫颈长度:技术与主要应用]

[Uterine cervical length measurement by endovaginal ultrasonography: Technique and main utilizations].

作者信息

Kayem G, Maillard F, Popowski T, Haddad B, Sentilhes L

机构信息

Service de gynécologie obstétrique, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun , 94000 Créteil, France.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2010 Jun;39(4):267-75. doi: 10.1016/j.jgyn.2010.03.005. Epub 2010 Apr 10.

Abstract

Cervical length measurement by transvaginal ultrasound is commonly used to assess the risk of preterm birth (PTB) and refine the clinical management in cases of preterm labor (PTL). The transvaginal route is considered to be the reference for the measurement of the uterine cervix. Cervical length measurement has a good diagnostic value irrespective of the clinical context or past history associated with an increased risk of PTB. In case of PTL, the measurement of the cervical length by ultrasonography allows to reduce the number of hospitalizations, and to focus on the women who really need a treatment. In case of twin pregnancy, systematic systematic measurement of cervical length at 20-25 weeks gestation is not recommended because of the lack of therapeutic applications. In cases of high risk of PTB (PTB history, conization, uterine exposure to DES, etc.), selecting a group at high risk for PTB by a systematic cervical length measurement at 20-25 weeks gestation could be useful to select women for whom treatment with progesterone would be most beneficial. In this group, a follow-up of the cervical length since 16 weeks gestation may also be useful to indicate a cerclage if the cervical length is less than 15mm. In the general population, cervical length measurement may be useful during the second trimester of pregnancy in so far as a treatment by progesterone in cases of short cervix (<or=15mm) may be beneficial.

摘要

经阴道超声测量宫颈长度常用于评估早产风险,并优化早产临产病例的临床管理。经阴道途径被视为测量子宫颈的参考方法。无论临床背景或与早产风险增加相关的既往史如何,宫颈长度测量都具有良好的诊断价值。在早产临产的情况下,通过超声测量宫颈长度可以减少住院人数,并将重点放在真正需要治疗的女性身上。对于双胎妊娠,由于缺乏治疗应用,不建议在妊娠20 - 25周时常规测量宫颈长度。在早产风险高的情况下(有早产史、宫颈锥切术、子宫暴露于己烯雌酚等),在妊娠20 - 25周时通过常规宫颈长度测量选择早产高风险组,可能有助于选择使用孕激素治疗最有益的女性。在该组中,自妊娠16周起对宫颈长度进行随访,如果宫颈长度小于15mm,也可能有助于指示是否进行宫颈环扎术。在一般人群中,妊娠中期测量宫颈长度可能有用,因为在宫颈短(≤15mm)的情况下,使用孕激素治疗可能有益。

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