Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece.
Prenat Diagn. 2011 Feb;31(2):202-6. doi: 10.1002/pd.2683. Epub 2011 Jan 4.
To develop a model for the prediction of short cervix ( ≤ 15 mm) at 20-24 weeks by combining maternal history and transvaginal ultrasonographic measurement of cervical length at 11-14 weeks. To explore the value of an additional ultrasound examination of the cervix at about 17 weeks.
Longitudinal prospective study in 800 unselected pregnant women presenting for first-trimester ultrasound assessment by nuchal translucency and serum biochemistry. Cervical length was evaluated transvaginally between 11 weeks and 13 weeks and 6 days (cx1), at 16-19 weeks (cx2) and 20-24 weeks (cx3). Backward multiple logistic regression analysis with cx3 ≤ 15 mm as the dependent variable was used to identify the predictors of a short cervix at 20-24 weeks.
Cx1 and history of preterm delivery were significant independent contributors of a short cervix at 20-24 weeks [area under the curve (AUC 0.808, p < 0.001, Model) 1]. Furthermore, the cx1/cx2 ratio was a significant independent predictor of a short cervix at 20-24 weeks (odds ratio = 58.325 p = 0.012). The addition of the cx1/cx2 ratio improved the model (AUC = 0.878, p < 0.001, Model 2).
A short cervix at 20-24 weeks can be predicted at the 11-14 weeks scan. The addition of a cervical measurement at about 17 weeks can improve the prediction model.
通过结合孕妇病史和 11-14 周经阴道超声测量宫颈长度，建立预测 20-24 周时短宫颈（≤15mm）的模型。探讨约 17 周时行额外的宫颈超声检查的价值。
对 800 例未经选择的孕妇进行前瞻性纵向研究，这些孕妇在孕早期进行了颈项透明层和血清生化检查。在 11 周到 13 周 6 天（cx1）、16-19 周（cx2）和 20-24 周（cx3）时经阴道评估宫颈长度。以 cx3≤15mm 为因变量，采用向后逐步逻辑回归分析确定 20-24 周时短宫颈的预测因素。
cx1 和早产史是 20-24 周时短宫颈的独立显著预测因素[曲线下面积（AUC）0.808，p<0.001，模型 1]。此外，cx1/cx2 比值是 20-24 周时短宫颈的独立显著预测因素（比值比=58.325，p=0.012）。cx1/cx2 比值的加入改善了模型（AUC=0.878，p<0.001，模型 2）。
可以在 11-14 周的扫描时预测 20-24 周时的短宫颈。约 17 周时行宫颈测量可提高预测模型的准确性。
