Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Chin Med Assoc. 2019 Jan;82(1):50-54. doi: 10.1016/j.jcma.2018.07.006.
Preterm labor is one of major obstetric challenges and can be predicted by cervical length at mid-trimester. In some settings, transvaginal ultrasound is not available and the screening and prevention of preterm labor will be suboptimal. We hope to find a correlation between other marker i.e. lower uterine wall thickness measured by transabdominal ultrasonography and cervical length measured by transvaginal ultrasonography in Thai pregnant women during 16-32 weeks of gestation.
This study was a cross-sectional study. 166 singleton pregnant women were invited to participate in the study between June 2015 and December 2015. Transabdominal ultrasonography was performed to measure the lower uterine wall thickness and transvaginal ultrasonography was performed to measure the cervical length. The Spearman's rank correlation was used to evaluate the correlation between the two parameters. The inter-observer variation was assessed by using Bland-Altman plot. The outcomes of all pregnancies were followed and only those who delivered at term were included for the calculation of normal value of lower uterine wall thickness.
There was a highly positive correlation between lower uterine wall thickness and cervical length (rs = 0.767, n = 166, p < 0.001). For those who had short cervical length (defined as less than 30 mm) at GA 16-24 weeks (n = 10), the mean corresponding lower uterine wall thickness was 4.4 mm (SD 0.50). The inter-observer variation of the measurement of lower uterine wall thickness and cervical length were small. The lower uterine wall thickness tended to be slightly thinner when the gestation advanced. (mean 5.4 mm at 16-20 weeks and 5.1 mm at 28-32 weeks).
There was a highly positive correlation between lower uterine wall thickness measured by transabdominal ultrasonography and cervical length measured by transvaginal ultrasonography in Thai pregnant women.
早产是产科的主要挑战之一，可以通过中孕期的宫颈长度来预测。在某些情况下，阴道超声不可用，早产的筛查和预防效果将不理想。我们希望在泰国孕妇 16-32 周的妊娠期间找到经阴道超声测量的宫颈长度与经腹部超声测量的子宫下段厚度之间的相关性。
这是一项横断面研究。我们于 2015 年 6 月至 12 月邀请了 166 名单胎孕妇参加了这项研究。通过经腹部超声测量子宫下段厚度，通过经阴道超声测量宫颈长度。采用 Spearman 秩相关来评估这两个参数之间的相关性。通过 Bland-Altman 图评估观察者间的变异。所有妊娠结局均进行随访，仅纳入足月分娩的孕妇计算子宫下段厚度的正常值。
子宫下段厚度与宫颈长度之间存在高度正相关（rs = 0.767，n = 166，p < 0.001）。对于在妊娠 16-24 周时宫颈长度较短（定义为小于 30mm）的孕妇（n = 10），相应的子宫下段厚度平均值为 4.4mm（SD 0.50）。子宫下段厚度和宫颈长度测量的观察者间变异较小。随着妊娠的进展，子宫下段厚度趋于变薄（孕 16-20 周时的平均值为 5.4mm，孕 28-32 周时为 5.1mm）。
在泰国孕妇中，经腹部超声测量的子宫下段厚度与经阴道超声测量的宫颈长度之间存在高度正相关。
