Kahyaoglu Serkan, Kahyaoglu Inci, Kaymak Oktay, Sagnic Saliha, Mollamahmutoglu Leyla, Danisman Nuri
Department of High Risk Pregnancy, Zekai Tahir Burak Women's Health and Research Hospital, Ankara, Turkey.
J Matern Fetal Neonatal Med. 2013 Jun;26(9):920-5. doi: 10.3109/14767058.2013.766703. Epub 2013 Feb 11.
Increased neonatal morbidity and mortality rates resulting from preterm delivery (PTD) remain as a problem despite increasing evidence about the physiology of uterine contractility process. More predictive signs of preterm labor detected on prenatal ultrasonography like the presence of cervical gland area (CGA) on transvaginal ultrasonography can be a reassuring finding among patients with threatened labor risk.
In this prospective study, 85 pregnant patients at 24-34 weeks of gestation who attended to our high risk pregnancy clinic for threatened labor between March 2011 and March 2012 have been examined by transvaginal ultrasonography to evaluate CGA located around the endocervical canal. Following discharge, the gestational week at birth, birth weight and birth route of patients have been recorded.
Among patients with a cervical length (CL) <30 mm and ≥30 mm measured by transvaginal ultrasonography on admission, 82.4% of the patients with a short cervix exhibiting echolucent endocervical glandular area and 42.3% of the patients with short cervix exhibiting echogen endocervical glandular area on sonography delivered at term (p = 0.013).
The presence of CGA detected on transvaginal ultrasonography especially when combined with the evaluation of CL during the management of patients with threatened labor can be a reassuring sign for actual probability of PTD.
尽管关于子宫收缩过程生理学的证据越来越多,但早产(PTD)导致的新生儿发病率和死亡率增加仍然是一个问题。产前超声检查发现的更多早产预测迹象,如经阴道超声检查时宫颈腺区(CGA)的存在,对于有早产风险的患者来说可能是一个令人安心的发现。
在这项前瞻性研究中,对2011年3月至2012年3月期间因早产风险到我们高危妊娠门诊就诊的85例妊娠24 - 34周的孕妇进行了经阴道超声检查,以评估宫颈管周围的CGA。出院后,记录患者的出生孕周、出生体重和分娩方式。
入院时经阴道超声测量宫颈长度(CL)<30 mm和≥30 mm的患者中,超声检查显示宫颈短且宫颈腺区无回声的患者中有82.4%足月分娩,宫颈短且宫颈腺区有回声的患者中有42.3%足月分娩(p = 0.013)。
经阴道超声检查发现CGA,尤其是在对有早产风险的患者进行管理时结合CL评估,对于PTD的实际可能性可能是一个令人安心的迹象。