15 毫米的宫颈长度截点能否区分有早产先兆的孕妇中低危和高危早产风险？

Can a 15-mm cervical length cutoff discriminate between low and high risk of preterm delivery in women with threatened preterm labor?

机构信息

Department of Fetal Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

出版信息

Fetal Diagn Ther. 2011;29(3):216-23. doi: 10.1159/000322131. Epub 2010 Dec 8.

DOI:10.1159/000322131

PMID:21150171

Abstract

OBJECTIVES

To investigate if a cervical length (CL) cutoff of 15 mm is relevant to use in women with threatened preterm labor.

METHODS

From 2006 to 2009, 146 women with singleton pregnancies were admitted with threatened preterm labor between 23 and 33+6 weeks of gestation at Copenhagen University Hospital. Transvaginal sonographic measurement of CL was carried out on admission. Outcome measures were spontaneous delivery within 48 h, within 7 days and delivery before 34 weeks according to a CL cutoff of 15 mm.

RESULTS

CL was <15 mm in 36 women (24.7%) and ≥15 mm in 110 women (75.3%). Spontaneous delivery occurred within 48 h or 7 days of presentation and before 34 weeks in 25, 38.9 and 50.0% of women with CL <15 mm and 3.6, 9.1 and 11.8% of women with CL ≥15 mm, respectively. The 15-mm CL cutoff had a sensitivity, false positive rate and negative predictive value for delivery within 48 h of 69.0, 20.3 and 96.4%, and within 7 days of 58.3, 18.1 and 90.9%. Women with CL <15 mm had odds of delivery within 7 days of 6.4 (95% CI 2.5-16.2).

CONCLUSION

Although a 15-mm CL defines a group of women at high risk of spontaneous preterm delivery, 10 out of 110 women (9.1%) with a CL ≥15 mm deliver within 7 days.

摘要

目的

探讨宫颈长度（CL）截断值为 15mm 是否适用于有早产先兆的妇女。

方法

2006 年至 2009 年，在哥本哈根大学医院，146 名单胎妊娠妇女在妊娠 23 周至 33+6 周之间因早产先兆入院。入院时行阴道超声测量 CL。结局指标为 48 小时内、7 天内和 34 周前根据 CL 截断值为 15mm 自发分娩。

结果

36 名妇女（24.7%）CL<15mm，110 名妇女（75.3%）CL≥15mm。CL<15mm 的妇女中，有 25%、38.9%和 50.0%在出现症状后 48 小时内、7 天内和 34 周前分娩，CL≥15mm 的妇女中，有 3.6%、9.1%和 11.8%分别在出现症状后 48 小时内、7 天内和 34 周前分娩。CL 截断值为 15mm 时，在出现症状后 48 小时内分娩的敏感度、假阳性率和阴性预测值分别为 69.0%、20.3%和 96.4%，在出现症状后 7 天内分娩的敏感度、假阳性率和阴性预测值分别为 58.3%、18.1%和 90.9%。CL<15mm 的妇女在 7 天内分娩的可能性是 CL≥15mm 妇女的 6.4 倍（95%CI 2.5-16.2）。