Rhoades Janine S, Park Jennifer M, Stout Molly J, Macones George A, Cahill Alison G, Tuuli Methodius G
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
Department of Obstetrics and Gynecology, Hartford Hospital, Hartford, Connecticut.
Am J Perinatol. 2016 Apr;33(5):473-9. doi: 10.1055/s-0035-1566308. Epub 2015 Nov 2.
This study aims to determine if transabdominal (TA) cervical length may be used to rule out a short cervix on transvaginal (TV) ultrasound.
We conducted a prospective cohort study of women undergoing routine anatomic survey at 17 to 23 weeks gestation. TA and TV cervical length measurements were obtained in each patient. A short cervix was defined as TV cervical length < 30 mm. Predictive characteristics were calculated for different cutoff values of TA cervical length.
There were 404 patients enrolled, a TA cervical length could not be obtained in 83 women (20.6%) and 318 women had both TA and TV measurements. Of those, 14 (4.4%) had a TV cervical length < 30 mm. TA cervical length measurement ≥ 35 mm excluded the possibility of TV cervical length < 30 mm (negative predictive value, 99.5%; 95% confidence interval [CI], 97.4; 100%). In our cohort, 67.6% (95% CI, 62.2; 72.7%) of TV ultrasounds could have been avoided using a TA cervical length cutoff of ≥ 5 mm.
ATA cervical length of at least 35 mm excludes a short cervix of < 30 mm. While TA cervical length screening may not be feasible in 1 in 5 women, it may be used to decrease the burden of universal TV cervical length screening.
本研究旨在确定经腹（TA）宫颈长度是否可用于经阴道（TV）超声检查时排除宫颈短的情况。
我们对妊娠17至23周接受常规解剖学检查的女性进行了一项前瞻性队列研究。对每位患者进行TA和TV宫颈长度测量。宫颈短定义为TV宫颈长度<30mm。计算不同TA宫颈长度临界值的预测特征。
共纳入404例患者，83例女性（20.6%）无法获得TA宫颈长度，318例女性同时进行了TA和TV测量。其中，14例（4.4%）TV宫颈长度<30mm。TA宫颈长度测量≥35mm排除了TV宫颈长度<30mm的可能性（阴性预测值为99.5%；95%置信区间[CI]，97.4；100%）。在我们的队列中，使用≥5mm的TA宫颈长度临界值可避免67.6%（95%CI，62.2；72.7%）的TV超声检查。
TA宫颈长度至少为35mm可排除<30mm的宫颈短情况。虽然五分之一的女性进行TA宫颈长度筛查可能不可行，但它可用于减轻普遍进行TV宫颈长度筛查的负担。
