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测量子宫颈角以预测有症状妇女的早产。

Measurement of the uterocervical angle for the prediction of preterm birth in symptomatic women.

机构信息

Department of Obstetrics and Gynaecology, University of Tuebingen, Calwerstrasse 7, 72076, Tübingen, Germany.

出版信息

Arch Gynecol Obstet. 2021 Sep;304(3):663-669. doi: 10.1007/s00404-021-06002-0. Epub 2021 Mar 5.

Abstract

PURPOSE

To examine if the uterocervical angle (UCA) can be used to predict preterm delivery in women with painful and regular uterine contractions and a cervical length of 25 mm or less.

METHODS

Retrospective study at the perinatal unit of the University Hospital of Tuebingen, Germany. Women with singleton gestation and preterm contractions between 24 + 0 and 33 + 6 weeks' gestation were included. For the UCA measurement, a line is placed from the internal os to the external os irrespective of whether the cervix is straight or curved. A second line is drawn to delineate the lower uterine segment. The angle between the two lines is the UCA measurement. The measurements were taken on stored images from our database.

RESULTS

The study consisted of 213 singleton pregnancies. At the time of UCA measurement, median maternal and gestational age was 31.4 years and 29.7 weeks' gestation. Median gestational age at delivery was 35.3 weeks and the corresponding birth weight 2480 g, respectively. The UCA measurement in women who delivered within 2 days, between 3-7 days and after 7 days was not helpful to distinguish between these three groups [median UCA measurements: 108.5°, 108.0° and 107.3° (Kruskal-Wallis test p = 0.576)]. Uni- and multivariate logistic multiple regression analysis demonstrated that the delivery within 2 days was only dependent on the gestational age and the cervical length at the time of presentation.

CONCLUSION

The measurement of UCA is not useful in predicting preterm birth in the subsequent 7 days after an episode of preterm contractions.

摘要

目的

探讨在出现有痛且规律宫缩并伴有宫颈管长度≤25mm 的孕妇中,子宫颈管和子宫下段交界(UCA)角度能否用于预测早产。

方法

这是德国图宾根大学医院围产医学科的一项回顾性研究。研究纳入了孕周 24+0 至 33+6 周且有早产宫缩的单胎妊娠孕妇。UCA 的测量方法是,无论宫颈是否弯曲,均从宫颈内口向宫颈外口画一条线,然后再画一条线以描绘下段子宫。两条线之间的夹角即为 UCA 测量值。这些测量值是从我们的数据库中存储的图像上获取的。

结果

该研究共纳入了 213 例单胎妊娠孕妇。UCA 测量时,孕妇的中位年龄和孕周分别为 31.4 岁和 29.7 孕周。中位分娩孕周为 35.3 周,对应的出生体重为 2480g。在 UCA 测量后 2 天内、3-7 天内和 7 天后分娩的孕妇中,UCA 测量值不能区分这三组[中位数 UCA 测量值分别为 108.5°、108.0°和 107.3°(Kruskal-Wallis 检验,p=0.576)]。单因素和多因素逻辑多元回归分析表明,2 天内分娩仅取决于就诊时的孕周和宫颈管长度。

结论

在出现早产宫缩后 7 天内,UCA 测量值对预测早产无帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abc5/8325658/e92ed9339bec/404_2021_6002_Fig1_HTML.jpg

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