经阴道超声测量宫颈长度预测双胎妊娠自发性早产：系统评价和荟萃分析。
Transvaginal sonographic cervical length for the prediction of spontaneous preterm birth in twin pregnancies: a systematic review and metaanalysis.
机构信息
Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, USA.
出版信息
Am J Obstet Gynecol. 2010 Aug;203(2):128.e1-12. doi: 10.1016/j.ajog.2010.02.064. Epub 2010 Jun 23.
OBJECTIVE
To assess the accuracy of transvaginal sonographic cervical length (CL) in predicting spontaneous preterm birth in women with twin pregnancies.
STUDY DESIGN
Systematic review and metaanalysis of predictive test accuracy.
RESULTS
Twenty-one studies (16 in asymptomatic women and 5 in symptomatic women) with a total of 3523 women met the inclusion criteria. Among asymptomatic women, a CL <or=20 mm at 20-24 weeks' gestation was the most accurate in predicting preterm birth <32 and <34 weeks' gestation (pooled sensitivities, specificities, and positive and negative likelihood ratios of 39% and 29%, 96% and 97%, 10.1 and 9.0, and 0.64 and 0.74, respectively). A CL <or=25 mm at 20-24 weeks' gestation had a pooled positive likelihood ratio of 9.6 to predict preterm birth <28 weeks' gestation. The predictive accuracy of CL for preterm birth was low in symptomatic women.
CONCLUSION
Transvaginal sonographic CL at 20-24 weeks' gestation is a good predictor of spontaneous preterm birth in asymptomatic women with twin pregnancies.
目的
评估经阴道超声宫颈长度（CL）在预测双胎妊娠妇女自发性早产中的准确性。
研究设计
预测试验准确性的系统评价和荟萃分析。
结果
共有 21 项研究（16 项在无症状妇女中，5 项在有症状妇女中）纳入了总共 3523 名妇女。在无症状妇女中，20-24 孕周时 CL <or=20mm 预测早产 <32 和 <34 孕周的准确性最高（汇总敏感性、特异性、阳性和阴性似然比分别为 39%和 29%、96%和 97%、10.1 和 9.0、0.64 和 0.74）。20-24 孕周时 CL <or=25mm 预测早产 <28 孕周的汇总阳性似然比为 9.6。CL 预测有症状妇女早产的准确性较低。
结论
20-24 孕周经阴道超声 CL 是预测双胎妊娠无症状妇女自发性早产的良好指标。
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