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胎盘弹性能否预测有早产先兆的分娩时间?

Can placental elasticity predict the time of delivery in cases of threatened preterm labor?

机构信息

Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.

出版信息

J Obstet Gynaecol Res. 2021 Feb;47(2):606-612. doi: 10.1111/jog.14570. Epub 2020 Nov 16.

Abstract

AIM

We aimed to evaluate placental elasticity for the short-time prediction of delivery in cases of threatened preterm labor (TPL).

METHODS

We performed a prospective study with consented pregnant women diagnosed with TPL (24th to 34th gestational week). According to the birth time, the patients were grouped into two groups, whether the delivery happened in the following first week or not. We compared the placental strain ratio (PSR) values between these two groups.

RESULTS

A total of 108 pregnant women divided into two groups according to the delivery time were enrolled in our study. The pregnant women who had a delivery in 1 week after hospitalization have increased PSR values when compared to those who have not delivered within 1 week (P < 0.001). Multivariate logistic regression analysis showed that cervical length and PSR were significantly associated with delivery in 1 week after hospitalization. When the cervical length was entered as a covariate (control) variable, PSR was significantly associated with delivery time (B = 0.504, odds ratio: 1.655, 95% confidence interval: 1.339-2.045, P < 0.001). A PSR value of 4.04 had a sensitivity of 77.78% and a specificity of 87.04% in terms of short-time prediction of the delivery time, in the receiver-operator curves analysis to determine the cut-off point PSR value.

CONCLUSION

Elastography may contribute to predict the delivery time in high-risk pregnants with TPL.

摘要

目的

评估胎盘弹性,以期对有早产先兆(TPL)的孕妇进行短期分娩预测。

方法

我们进行了一项前瞻性研究,纳入了被诊断为 TPL(妊娠 24 至 34 周)的孕妇。根据分娩时间,患者被分为分娩发生在接下来的一周内和未发生在接下来的一周内两组。我们比较了这两组的胎盘应变比(PSR)值。

结果

根据分娩时间,我们共纳入了 108 名孕妇,将其分为两组。与未在 1 周内分娩的孕妇相比,住院后 1 周内分娩的孕妇 PSR 值更高(P<0.001)。多变量逻辑回归分析显示,宫颈长度和 PSR 与住院后 1 周内分娩显著相关。当宫颈长度作为协变量(对照)变量时,PSR 与分娩时间显著相关(B=0.504,优势比:1.655,95%置信区间:1.339-2.045,P<0.001)。在受试者工作特征曲线分析中,PSR 值为 4.04 时,短期预测分娩时间的敏感度为 77.78%,特异性为 87.04%,确定 PSR 值的截断点。

结论

超声弹性成像技术可能有助于预测有早产先兆的高危孕妇的分娩时间。

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