Aslan Cetin Berna, Aydogan Mathyk Begum, Koroglu Nadiye, Demirezen Gozde, Turan Gokce, Demirayak Gokhan, Yildirim Gokhan
a Department of Obstetrics and Gynecology , Research and Training Hospital , Istanbul , Turkey.
b Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology , University of North Carolina , Chapel Hill , NC , USA.
J Matern Fetal Neonatal Med. 2019 Nov;32(22):3812-3817. doi: 10.1080/14767058.2018.1472762. Epub 2018 May 17.
To show how uterocervical angles are used for the prediction of second-trimester pregnancy terminations in multiparous women. A total of 148 multiparous singleton women in their second trimesters were enrolled in this prospective study. The intracervical Foley catheter was used for the induction of delivery. The cervical length (CL) and the uterocervical angle (UCA) were measured before the beginning of induction. The study population was subdivided into four groups; successful and failed terminations at the end of 24 and 48 h time frames. A stepwise multiple regression analysis was carried out to examine the contribution of UCA and other parameters to the induction-to-delivery time. A survival analysis was conducted to compare two groups defined by the cut-off value. The UCA was broader in the successful termination group compared to the failed termination group in 24 h of induction (112.50° ± 29.00° versus 100.68° ± 27.13°, = .02). A negative correlation was found between the UCA and the induction-to-delivery time ( = -0.27, = .0007). A cut-off value of 97.5° was found for the UCA in predicting induction outcomes. During the 24-h period, 63.1% of women with the UCA ≥97.5° terminated successfully while 36.8% of women with the UCA <97.5° terminated successfully ( = .001). The mean induction-to-delivery time was significantly shorter in the UCA ≥97.5° group compared to the UCA <97.5° group (38.2 ± 19.5 h versus 47.8 ± 27.5 h, = .02). The binary logistic regression analysis showed that the UCA was the only contributor to a successful termination (OR = 1.01, 95% CI: 1-1.02, = .02). The UCA is broader in multiparous women who successfully terminated and is linked to a shorter duration of induction. The UCA by itself is the only significant contributor to the outcome of second trimester pregnancy terminations.
展示子宫颈角度如何用于预测经产妇中期妊娠终止情况。本前瞻性研究共纳入148名处于孕中期的经产妇单胎孕妇。使用宫颈内Foley导管引产。引产开始前测量宫颈长度（CL）和子宫颈角度（UCA）。研究人群分为四组：24小时和48小时时间框架结束时引产成功和失败的组。进行逐步多元回归分析，以检验UCA和其他参数对引产至分娩时间的影响。进行生存分析以比较由临界值定义的两组。引产24小时时，成功终止组的UCA比失败终止组更宽（112.50°±29.00°对100.68°±27.13°，P = 0.02）。发现UCA与引产至分娩时间呈负相关（r = -0.27，P = 0.0007）。发现UCA预测引产结局的临界值为97.5°。在24小时期间，UCA≥97.5°的女性中有63.1%引产成功，而UCA<97.5°的女性中有36.8%引产成功（P = 0.001）。UCA≥97.5°组的平均引产至分娩时间明显短于UCA<97.5°组（38.2±19.5小时对47.8±27.5小时，P = 0.02）。二元逻辑回归分析表明，UCA是引产成功的唯一因素（OR = 1.01，95%CI：1 - 1.02，P = 0.02）。成功终止妊娠的经产妇UCA更宽，且与较短的引产持续时间相关。UCA本身是中期妊娠终止结局的唯一重要因素。
