Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children's Health Training and Research Hospital, Istanbul, Turkey.
J Matern Fetal Neonatal Med. 2020 Apr;33(8):1295-1301. doi: 10.1080/14767058.2018.1517324. Epub 2018 Sep 25.
A wide uterocervical angle >95° detected during the second trimester was associated with an increased risk for spontaneous preterm birth. We aimed to determine whether an ultrasonographic marker, uterocervical angle, correlates with satisfactory response to labor induction. We conducted a prospective cohort study from May 2016 through December 2017 of singleton term gestations undergoing transvaginal ultrasound for cervical length screening and uterocervical angle measurement. Uterocervical angle was measured between the lower uterine segment and the cervical canal. Latent phase duration >720 min was accepted to be a prolonged latent phase. The primary outcome was a prediction of satisfactory response to labor induction (latent phase duration <720 min). Both anterior uterocervical angle (AUC = 0.802, < .001) and the cervical length (AUC = 0.679, < .05) significantly predicted satisfactory response to labor induction. Optimal cutoff value was obtained at the value of 97° (64% sensitivity, 91% specificity) for anterior uterocervical angle and 27 mm (64% sensitivity, 64% specificity) for the cervical length. Kaplan-Meier survival analysis showed that duration from labor induction to delivery was significantly higher in a group with longer cervical length ( = .04), additionally labor induction to delivery time was significantly higher in a group with lower UCA ( = .04). Both the cervical length and anterior uterocervical length were predictors for the satisfactory response to labor induction, and both parameters were found to be significantly associated with time from induction to delivery in survival analysis.
在妊娠中期检测到的宽子宫颈角>95°与自发性早产风险增加相关。我们旨在确定超声标志物子宫颈角是否与分娩诱导的满意反应相关。我们进行了一项前瞻性队列研究，纳入了 2016 年 5 月至 2017 年 12 月期间因宫颈长度筛查和子宫颈角测量而行经阴道超声检查的单胎足月妊娠患者。子宫颈角在子宫下段和宫颈管之间测量。潜伏期持续时间>720 分钟被认为是潜伏期延长。主要结局是预测分娩诱导的满意反应（潜伏期持续时间<720 分钟）。前子宫颈角（AUC=0.802，<0.001）和宫颈长度（AUC=0.679，<0.05）均显著预测分娩诱导的满意反应。最佳截断值在前子宫颈角为 97°（64%敏感性，91%特异性），宫颈长度为 27mm（64%敏感性，64%特异性）。Kaplan-Meier 生存分析显示，宫颈长度较长的组从分娩诱导到分娩的持续时间明显更高（=0.04），此外，UCA 较低的组从诱导到分娩的时间明显更高（=0.04）。宫颈长度和前子宫颈长度均为分娩诱导满意反应的预测因素，在生存分析中，这两个参数均与诱导至分娩的时间显著相关。
