Wagner P, Sonek J, Heidemeyer M, Schmid M, Abele H, Hoopmann M, Kagan K O
Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany.
Fetal Medicine Foundation USA, Dayton, OH, USA; Division of Maternal Fetal Medicine, Wright State University, Dayton, OH, USA.
Geburtshilfe Frauenheilkd. 2016 Jul;76(7):779-784. doi: 10.1055/s-0042-104282.
To examine the value of a repeat measurement some days after the first cervical length measurement done at the time of preterm contractions.
Retrospective study involving women with singleton pregnancies who presented with preterm contractions at 24 to 33 + 6 weeks of gestation. The cervical length was measured at the time of presentation and some days afterwards.
The study population consisted of 17 cases with a preterm delivery within 14 days and 288 uneventful pregnancies. Univariate logistic regression analysis indicated a significant correlation between delivery within 14 days and both, the first and second cervical length measurements as well as the difference between the two measurements. Up to a false positive rate of 20 %, ROC curve analysis showed an improved detection rate for preterm delivery by inluding both measurements. At a false positive rate of 10 % - which corresponds to a first and second cervical length of 10 and 9 mm - the detection rate was 17.6 % with the first cervical length measurement, 47.0 % with the second and 52.9 % if the difference between both measurements was added.
Our results indicate that in women with symptoms of preterm labor it is worth to repeat the measurement some days later and to take into account the difference between both measurements.
探讨在早产宫缩时首次测量宫颈长度几天后进行重复测量的价值。
对妊娠24至33⁺⁶周出现早产宫缩的单胎妊娠女性进行回顾性研究。在就诊时及几天后测量宫颈长度。
研究人群包括17例在14天内早产的病例和288例妊娠结局良好的病例。单因素逻辑回归分析表明，14天内分娩与首次和第二次宫颈长度测量以及两次测量之间的差异均存在显著相关性。在假阳性率高达20%的情况下，ROC曲线分析显示，纳入两次测量可提高早产的检测率。在假阳性率为10%（对应首次和第二次宫颈长度分别为10毫米和9毫米）时，首次宫颈长度测量的检测率为17.6%，第二次为47.0%，若加上两次测量之间的差异则为52.9%。
我们的结果表明，对于有早产症状的女性，几天后重复测量并考虑两次测量之间的差异是值得的。
