Marsoosi Vajiheh, Pirjani Reihaneh, Asghari Jafarabadi Mohamad, Mashhadian Mina, Ziaee Saeedeh, Moini Ashraf
Perinatology Division, Obstetrics and Gynecology Department, Tehran University of Medical Sciences, Tehran, Iran.
Obstetrics and Gynecology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Int J Reprod Biomed. 2017 Nov;15(11):729-734.
Preterm labor is a major cause of perinatal morbidity and mortality and it might be predicted by assessing the cervical change.
To assess the association between absence of cervical gland area (CGA) and spontaneous preterm labor (SPTL).
This prospective cohort study was performed on 200 singleton pregnant women with a history of SPTL, second-trimester abortion in the previous pregnancy or lower abdominal pain in current pregnancy. Each patient underwent one transvaginal ultrasound examination between 14-28 wk of gestation. Cervical length was measured and CGA was identified and their relationship with SPTL before 35 and 37 wk gestation was evaluated using STATA software version 10.
The mean of cervical length was 36.5 mm (SD=8.4), the shortest measurement was 9 mm, and the longest one was 61 mm. Short cervical length (≤18mm) was significantly associated with SPTL before 35 and 37 wk gestation.Cervical gland area (the hypoechogenic or echogenic area around the cervical canal) was present in 189 (94.5%) patients. Absent of CGA had a significant relationship with SPTL before 35 and 37 wk gestation (p=0.01 and p<0.001, respectively). Cervical length was shorter in women with absent CGA in comparison with subjects with present CGA: 37±10 mm in CGA present group and 23±9 mm in CGA absent group (p<0.001).
Our study showed that cervical gland area might be an important predictor of SPTL which should be confirmed with further researches.
早产是围产期发病和死亡的主要原因，通过评估宫颈变化可能对其进行预测。
评估宫颈腺体区域（CGA）缺失与自发性早产（SPTL）之间的关联。
本前瞻性队列研究对200名单胎孕妇进行，这些孕妇有自发性早产史、既往妊娠中期流产史或当前妊娠下腹疼痛史。每位患者在妊娠14 - 28周期间接受一次经阴道超声检查。测量宫颈长度并识别宫颈腺体区域，使用STATA 10软件评估它们与妊娠35周和37周前自发性早产的关系。
宫颈长度的平均值为36.5毫米（标准差 = 8.4），最短测量值为9毫米，最长为61毫米。短宫颈长度（≤18毫米）与妊娠35周和37周前的自发性早产显著相关。189名（94.5%）患者存在宫颈腺体区域（宫颈管周围的低回声或高回声区域）。宫颈腺体区域缺失与妊娠35周和37周前的自发性早产有显著关系（分别为p = 0.01和p < 0.001）。与存在宫颈腺体区域的受试者相比，宫颈腺体区域缺失的女性宫颈长度较短：宫颈腺体区域存在组为37±10毫米，宫颈腺体区域缺失组为23±9毫米（p < 0.001）。
我们的研究表明，宫颈腺体区域可能是自发性早产的重要预测指标，这一点应通过进一步研究加以证实。
