Luechathananon Sireethorn, Songthamwat Metha, Chaiyarach Sukanya
Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Department of Obstetrics and Gynaecology, Udonthani Hospital, Udon Thani, Thailand.
Int J Womens Health. 2021 Feb 3;13:153-159. doi: 10.2147/IJWH.S283132. eCollection 2021.
To evaluate the diagnostic performance of uterocervical angle (UCA) and UCA with cervical length (CL) in predicting preterm delivery in threatened preterm labor.
A multicenter prospective observational cohort study was conducted in 160 pregnant women having threatened preterm labor at Srinagarind and Udonthani Hospitals in Thailand between March 2019 and June 2020. Researchers measured UCA and CL by transvaginal ultrasonography. Medical records were reviewed for patient characteristics, and patients were followed up until the date of delivery to assess for the outcome of preterm birth. The cut-off point of UCA was determined from receiver operating characteristic curve analysis. The sensitivity, specificity, likelihood ratio, positive and negative predictive values (PPV and NPV) of UCA and of UCA with CL for predicting preterm birth were determined.
The incidence of preterm birth in women having threatened preterm labor was 27%. The sensitivity, specificity, PPV and NPV of UCA ≥110.97 degrees for predicting preterm birth were 65.1%, 43.6%, 29.8% and 77.3%, respectively. The sensitivity, specificity, PPV and NPV of UCA ≥110.97 degrees with CL <3.4 centimeters for predicting preterm birth were 48.8%, 68.4%, 36.2% and 78.4%. The specificity and NPV of UCA with CL were higher than for UCA alone.
With adequate sensitivity and high NPV, UCA by TVS can be supplemented with CL measurement in threatened preterm labor management to increase the diagnostic performance for predicting preterm birth.
评估子宫颈角度（UCA）及联合宫颈长度（CL）预测先兆早产患者早产的诊断效能。
2019年3月至2020年6月，在泰国诗里拉吉医院和乌隆他尼医院对160例先兆早产孕妇进行了一项多中心前瞻性观察队列研究。研究人员通过经阴道超声测量UCA和CL。回顾病历以了解患者特征，并对患者进行随访直至分娩日期，以评估早产结局。通过受试者工作特征曲线分析确定UCA的截断点。确定UCA及联合CL预测早产的敏感度、特异度、似然比、阳性预测值和阴性预测值（PPV和NPV）。
先兆早产女性的早产发生率为27%。UCA≥110.97度预测早产的敏感度、特异度、PPV和NPV分别为65.1%、43.6%、29.8%和77.3%。UCA≥110.97度且CL<3.4厘米预测早产的敏感度、特异度、PPV和NPV分别为48.8%、68.4%、36.2%和78.4%。联合CL的UCA的特异度和NPV高于单独的UCA。
经阴道超声测量的UCA具有足够的敏感度和较高的NPV，在先兆早产管理中可补充CL测量以提高预测早产的诊断效能。
