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在没有宫颈长度测量的情况下,在中期妊娠无症状患者中即将发生早产的风险。

The risk of impending preterm delivery in asymptomatic patients with a nonmeasurable cervical length in the second trimester.

机构信息

Perinatology Research Branch, Intramural Division, National Institute of Child Health and Human Development/NIH/DHHS, Bethesda, MD 20892, USA.

出版信息

Am J Obstet Gynecol. 2010 Nov;203(5):446.e1-9. doi: 10.1016/j.ajog.2010.05.040. Epub 2010 Jul 24.

DOI:10.1016/j.ajog.2010.05.040
PMID:20659728
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3600362/
Abstract

OBJECTIVE

The purpose of this study was to determine the pregnancy outcome of asymptomatic patients in the second trimester with a nonmeasurable cervical length (0 mm).

STUDY DESIGN

This retrospective cohort study included 78 patients with singleton pregnancies and a sonographic nonmeasurable cervix that was detected at 14-28 weeks of gestation. Patients with cervical cerclage were excluded.

RESULTS

We found that (1) 75.3% of the patients delivered before 32 weeks of gestation; (2) the median diagnosis-to-delivery interval was 20.5 days, and the delivery rate within 7 and 14 days was 28.2% and 35.6%, respectively; and (3) patients with a nonmeasurable cervix that was diagnosed at <24 weeks of gestation had a shorter median diagnosis-to-delivery interval than patients who were diagnosed at 24-28 weeks of gestation (17.5 vs 41 days; P = .009).

CONCLUSION

Asymptomatic women with a nonmeasurable cervix in the second trimester have a median diagnosis-to-delivery interval of approximately 3 weeks. Almost 65% of these patients will not deliver within 2 weeks, yet 75% of them will deliver before 32 weeks of gestation. The earlier a nonmeasurable cervix is identified, the shorter the diagnosis-to-delivery interval.

摘要

目的

本研究旨在探讨中孕期宫颈长度不可测(0mm)的无症状患者的妊娠结局。

研究设计

本回顾性队列研究纳入了 78 例单胎妊娠且超声检查提示宫颈不可测的患者,这些患者的妊娠时间在 14-28 周之间。排除行宫颈环扎术的患者。

结果

我们发现(1)75.3%的患者在 32 周前分娩;(2)中位诊断至分娩间隔为 20.5 天,7 天和 14 天内的分娩率分别为 28.2%和 35.6%;(3)妊娠 24 周前诊断为宫颈不可测的患者,其中位诊断至分娩间隔短于妊娠 24-28 周时诊断为宫颈不可测的患者(17.5 天比 41 天;P=0.009)。

结论

中孕期宫颈不可测的无症状患者的中位诊断至分娩间隔约为 3 周。近 65%的患者在 2 周内不会分娩,但 75%的患者会在 32 周前分娩。宫颈不可测的诊断时间越早,诊断至分娩的间隔越短。

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本文引用的文献

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Patients with an asymptomatic short cervix (<or=15 mm) have a high rate of subclinical intraamniotic inflammation: implications for patient counseling.无症状短宫颈(<或=15mm)患者亚临床羊膜腔内炎症发生率较高:对患者咨询的意义。
Am J Obstet Gynecol. 2010 May;202(5):433.e1-8. doi: 10.1016/j.ajog.2010.02.007.
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Multicenter randomized trial of cerclage for preterm birth prevention in high-risk women with shortened midtrimester cervical length.多中心随机试验:针对孕中期宫颈长度缩短的高危女性采用宫颈环扎术预防早产
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Induced termination of pregnancy and low birthweight and preterm birth: a systematic review and meta-analyses.人工终止妊娠与低出生体重儿及早产儿:系统评价与荟萃分析。
BJOG. 2009 Oct;116(11):1425-42. doi: 10.1111/j.1471-0528.2009.02278.x.
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Comprehensive amniotic fluid cytokine profile evaluation in women with a short cervix: which cytokine(s) correlates best with outcome?宫颈短的女性羊水中细胞因子谱的综合评估:哪种细胞因子与结局的相关性最佳?
Am J Obstet Gynecol. 2009 Sep;201(3):276.e1-6. doi: 10.1016/j.ajog.2009.05.045.
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Is midtrimester short cervix a sign of intraamniotic inflammation?孕中期宫颈短是羊膜腔内炎症的迹象吗?
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Cervical length and obstetric history predict spontaneous preterm birth: development and validation of a model to provide individualized risk assessment.宫颈长度和产科病史可预测自发性早产:一种提供个体化风险评估模型的开发与验证
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