Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama, Birmingham, AL, USA.
Am J Obstet Gynecol. 2010 Sep;203(3):259.e1-5. doi: 10.1016/j.ajog.2010.07.002.
The purpose of this study was to assess funnel type and pregnancy duration in women with previous spontaneous preterm birth and cervical length <25 mm.
We performed a secondary analysis of a multicenter randomized trial of cerclage. At the randomization scan that documented short cervix, the presence and type of funnel (U or V) were recorded.
One hundred forty-seven of 301 women (49%) had funneling: V-shaped funnel, 99 women; U-shaped funnel, 48 women. U-shaped funnel was associated significantly with preterm birth at <24, <28, <35, and <37 weeks of gestation. In multivariable models that controlled for randomization cervical length and cerclage, women with U-shaped funnel delivered earlier than women with either V-shaped funnel or no funnel. Interaction between cerclage and U-shaped funnel was observed, and analyses that were stratified by cerclage showed that women with a U-shaped funnel and cerclage delivered at a mean of 33.8 +/- 6.6 weeks of gestation, compared with women who did not receive cerclage (28.9 +/- 6.9 weeks of gestation).
U-shaped funnels in high-risk women with a short cervix are associated with earlier birth.
本研究旨在评估有自发性早产史且宫颈长度<25mm 的女性的漏斗类型和妊娠持续时间。
我们对一项多中心宫颈环扎术随机试验进行了二次分析。在记录宫颈短的随机扫描中，记录了漏斗（U 形或 V 形）的存在和类型。
在 301 名女性中，有 147 名（49%）出现漏斗：V 形漏斗 99 例，U 形漏斗 48 例。U 形漏斗与<24、<28、<35 和<37 周的早产显著相关。在控制随机宫颈长度和环扎术的多变量模型中，U 形漏斗的女性比 V 形漏斗或无漏斗的女性更早分娩。观察到环扎术和 U 形漏斗之间存在交互作用，并且根据环扎术分层的分析表明，有 U 形漏斗和环扎术的女性的平均分娩孕周为 33.8 +/- 6.6 周，而未接受环扎术的女性的平均分娩孕周为 28.9 +/- 6.9 周。
在宫颈短的高危女性中，U 形漏斗与早产提前有关。
