经阴道子宫肌电图预测早产。
Noninvasive uterine electromyography for prediction of preterm delivery.
机构信息
Department of Obstetrics and Gynecology, St Joseph's Hospital and Medical Center, 445 N. 5th Street, Phoenix, AZ 85004, USA.
出版信息
Am J Obstet Gynecol. 2011 Mar;204(3):228.e1-10. doi: 10.1016/j.ajog.2010.09.024. Epub 2010 Dec 8.
OBJECTIVE
Power spectrum (PS) of uterine electromyography (EMG) can identify true labor. EMG propagation velocity (PV) to diagnose labor has not been reported. The objective was to compare uterine EMG against current methods to predict preterm delivery.
STUDY DESIGN
EMG was recorded in 116 patients (preterm labor, n = 20; preterm nonlabor, n = 68; term labor, n = 22; term nonlabor, n = 6). A Student t test was used to compare EMG values for labor vs nonlabor (P < .05, significant). Predictive values of EMG, Bishop score, contractions on tocogram, and transvaginal cervical length were calculated using receiver-operator characteristics analysis.
RESULTS
PV was higher in preterm and term labor compared with nonlabor (P < .001). Combined PV and PS peak frequency predicted preterm delivery within 7 days with area under the curve (AUC) of 0.96. Bishop score, contractions, and cervical length had an AUC of 0.72, 0.67, and 0.54.
CONCLUSION
Uterine EMG PV and PS peak frequency more accurately identify true preterm labor than clinical methods.
目的
子宫肌电图（EMG）的功率谱（PS）可识别真性临产。EMG 传播速度（PV）用于诊断临产尚未有报道。本研究旨在比较子宫 EMG 与目前用于预测早产的方法。
研究设计
记录了 116 例患者（早产临产，n=20；早产未临产，n=68；足月临产，n=22；足月未临产，n=6）的 EMG。采用 Student t 检验比较临产与未临产的 EMG 值（P<.05，差异有统计学意义）。采用受试者工作特征曲线分析计算 EMG、Bishop 评分、宫缩图宫缩和经阴道宫颈长度的预测值。
结果
早产和足月临产的 PV 均高于未临产（P<.001）。PV 和 PS 峰频率联合预测 7 天内早产的曲线下面积（AUC）为 0.96。Bishop 评分、宫缩和宫颈长度的 AUC 分别为 0.72、0.67 和 0.54。
结论
与临床方法相比，子宫 EMG 的 PV 和 PS 峰频率更能准确识别真性早产临产。
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