Diawtipsukon Sanpon, Bumrungphuet Sommart, Dulyaphat Wirada, Panburana Panyu
Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Int J Womens Health. 2020 Aug 21;12:649-656. doi: 10.2147/IJWH.S251522. eCollection 2020.
To compare the cervical shear wave elastography (SWE) by using transvaginal ultrasound (TVS) between twin and singleton pregnant women.
This was a prospective cohort study involving the twin and singleton pregnant women who attended the antenatal care at Ramathibodi Hospital, Bangkok, Thailand. The participants who met the inclusion criteria were serially measured the shear wave speed (SWS) by using TVS at early, mid-, and third trimester. The changes in SWS with advancing gestational age between twin and singleton pregnancies were evaluated. The gestational age at delivery and spontaneous preterm delivery rate were also analyzed.
A total of 36 twin pregnancies and 38 singleton pregnancies were analyzed. No significant difference in baseline characteristics, except the age of participants (twin pregnancies 33.1±4.6 years, singleton pregnancies 29.9±5.4 years, p-value = 0.006) was observed. The cervical SWS decreased with advancing gestational age in both twin and singleton pregnancy, but there was a statistically significant difference of cervical SWS at the lower point in mid-trimester (twin pregnancies 2.27±0.4, singleton pregnancies 2.71±0.6 m/s, p-value = 0.001). However, no significant difference in cervical SWS at the upper point and the lower point in the early and third trimester was demonstrated. Even though the gestational age at delivery between both groups revealed a significant difference (twin pregnancies 35.9±2.8, singleton pregnancies 37.6±2.9 wk., p-value = 0.008) but the spontaneous preterm delivery rate did not differ significantly (twin pregnancies 22.2%, singleton pregnancies 15.8%, p-value = 0.483).
The mid-trimester cervical SWS measurement at the lower point detects the difference in cervical softness between twin pregnancies and singleton pregnancies. The cervical SWS might be an additional option for monitoring the change in cervical softness in twin pregnancies.
比较经阴道超声（TVS）对双胎和单胎孕妇进行宫颈剪切波弹性成像（SWE）的情况。
这是一项前瞻性队列研究，纳入了在泰国曼谷拉玛蒂博迪医院接受产前检查的双胎和单胎孕妇。符合纳入标准的参与者在孕早期、孕中期和孕晚期使用TVS连续测量剪切波速度（SWS）。评估双胎和单胎妊娠中SWS随孕周增加的变化。还分析了分娩时的孕周和自然早产率。
共分析了36例双胎妊娠和38例单胎妊娠。除参与者年龄外（双胎妊娠33.1±4.6岁，单胎妊娠29.9±5.4岁，p值 = 0.006），未观察到基线特征有显著差异。双胎和单胎妊娠中宫颈SWS均随孕周增加而降低，但在孕中期最低点时宫颈SWS存在统计学显著差异（双胎妊娠2.27±0.4，单胎妊娠2.71±0.6米/秒，p值 = 0.001）。然而，在孕早期和孕晚期的最高点和最低点，宫颈SWS无显著差异。尽管两组之间的分娩孕周存在显著差异（双胎妊娠35.9±2.8，单胎妊娠37.6±2.9周，p值 = 0.008），但自然早产率无显著差异（双胎妊娠22.2%，单胎妊娠15.8%，p值 = 0.483）。
孕中期最低点的宫颈SWS测量可检测出双胎妊娠和单胎妊娠宫颈柔软度的差异。宫颈SWS可能是监测双胎妊娠宫颈柔软度变化的另一种选择。
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