中孕期阴道 pH 值和宫颈长度作为低危人群早产的筛查预测指标。

Vaginal pH versus cervical length in the mid-trimester as screening predictors of preterm labor in a low-risk population.

机构信息

University Department of Obstetrics and Gynecology, School of Medicine, Sveti Duh Hospital, Zagreb, Croatia.

出版信息

Int J Gynaecol Obstet. 2010 Oct;111(1):41-4. doi: 10.1016/j.ijgo.2010.05.011. Epub 2010 Jul 7.

DOI:10.1016/j.ijgo.2010.05.011

PMID:20615503

Abstract

OBJECTIVE

To assess the accuracy of a sign of bacterial vaginosis and a sign of cervical insufficiency in predicting preterm labor (PTL, occurring in the 37th week or earlier) and early PTL (occurring in the 34th week or earlier) in a low-risk cohort of 316 pregnant women.

METHOD

Vaginal pH was assessed using test gloves and cervical length (CL) was measured by transvaginal ultrasound. A pH value less than 5.0 (the 95th-percentile threshold) and a CL greater than 26 mm (the 5th-percentile threshold) were considered normal.

RESULTS

There were 14 participants (4.4%) with an elevated vaginal pH and 15 (4.7%) with a shortened CL. The incidence of PTL (<37 weeks) was 7.2%, while incidence of early PTL (≤34 weeks) was 2.5%. A shortened CL was significantly correlated with PTL (likelihood ratio [LR] weighted by prevalence; 2.7; 95% CI, 1.1-6.7) but not with early PTL (LR, 0.8; 95% CI, 0.4-1.8). An elevated vaginal pH was a better predictor of PTL (LR, 3.7; 95% CI, 1.3-10.4) and early PTL (LR, 1.7; 95% CI, 1.1-3.1).

CONCLUSION

An elevated vaginal pH was a better predictor of early PTL than a shortened CL in this cohort of pregnant women at low risk.

摘要

目的

评估细菌性阴道病征象和宫颈机能不全征象在预测低危孕妇早产（发生在第 37 周或更早）和早期早产（发生在第 34 周或更早）中的准确性，共纳入 316 名孕妇。

方法

使用测试手套评估阴道 pH 值，经阴道超声测量宫颈长度（CL）。pH 值小于 5.0（第 95 百分位数阈值）和 CL 大于 26 mm（第 5 百分位数阈值）被认为是正常的。

结果

有 14 名（4.4%）参与者阴道 pH 值升高，15 名（4.7%）CL 缩短。早产（<37 周）的发生率为 7.2%，而早期早产（≤34 周）的发生率为 2.5%。CL 缩短与早产（LR，经患病率加权；2.7；95%CI，1.1-6.7）显著相关，但与早期早产（LR，0.8；95%CI，0.4-1.8）无关。阴道 pH 值升高是早产（LR，3.7；95%CI，1.3-10.4）和早期早产（LR，1.7；95%CI，1.1-3.1）更好的预测指标。