Department of Obstetrics and Gynecology , Nippon Medical School, Musashikosugi Hospital, Kawasaki City, Kanagawa, Japan.
J Perinat Med. 2013 Mar;41(2):151-7. doi: 10.1515/jpm-2012-0112.
Transvaginal sonographic findings of an absent cervical gland area (CGA) and a short cervical length (CL) are frequently observed in patients with threatened preterm delivery. The present study aimed to clarify whether sonographic findings are due to active production of hyaluronic acid (HA)in the cervix.
Possible relationships between sonographic findings of the presence or absence of the CGA and/or a short CL and cervical mucus HA concentration were investigated in 68 women with threatened preterm delivery at 22 – 31 weeks’ gestation and 136 women without threatened preterm delivery as controls.
HA levels were higher in women with threatened preterm delivery (68.0 ng/mL) than in controls (39.0 ng/mL; P = 0.001). Similarly, HA levels were higher in women with preterm labor showing an absent CGA and a short CL than in women with threatened preterm delivery without such findings (P < 0.01). Stepwise multivariate logistic regression identified an absent CGA and threatened preterm delivery as independent predictors of high HA levels (P = 0.04). HA concentration was not predictive for preterm delivery.
A sonographic finding of an absent CGA reflects high HA levels in the cervix with threatened preterm delivery.
经阴道超声检查发现宫颈腺区（CGA）缺失和宫颈长度短（CL）在有早产风险的患者中经常观察到。本研究旨在阐明超声表现是否归因于宫颈中透明质酸（HA）的活跃产生。
在 22-31 孕周有早产风险的 68 名孕妇和 136 名无早产风险的孕妇中，研究了 CGA 存在或缺失以及 CL 短的超声表现与宫颈黏液 HA 浓度之间的可能关系。
有早产风险的孕妇（68.0ng/mL）HA 水平高于对照组（39.0ng/mL；P=0.001）。同样，在有早产风险且 CGA 缺失和 CL 短的孕妇中，HA 水平高于无这些发现的有早产风险的孕妇（P<0.01）。逐步多元逻辑回归确定 CGA 缺失和早产风险是 HA 水平升高的独立预测因子（P=0.04）。HA 浓度不能预测早产。
超声检查发现 CGA 缺失反映了有早产风险的宫颈中 HA 水平升高。
