Mitsuzuka Kanako, Togo Atsuko, Nakajima Rie, Kanno Yasuhira, Sato Kenji, Ishimoto Hitoshi
Department of Obstetrics and Gynecology, Specialized Clinical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2022 Dec 20;47(4):204-208.
Placenta previa complicates 0.3-0.5% of pregnancies and can cause sudden antepartum massive hemorrhage (APH). Previous studies have indicated that cervical length (CL) measured by transvaginal ultrasonography may be a predicting parameter for APH in patients with placenta previa; however, conflicting data exist. Thus, we investigated the association between CL and APH in patients with placenta previa.
In total, 129 singleton pregnant women with placenta previa, who delivered at our institution from January 2010 to December 2016, were included in this study. The shortest CL measured throughout gestation was used for analysis, and we defined CL less or more than 30 mm as short or normal CL, respectively. We performed univariate and multivariate analyses, and a receiver-operating characteristics (ROC) curve was plotted to determine the cut-off CL value to predict APH.
APH occurred in 26 patients. The adjusted odds ratio for APH was 3.80 (95% CI, 1.36-10.65) in patients with short CL. ROC analysis was performed to determine a cut-off CL value of 35 mm to predict APH, with a sensitivity of 80.7% and a specificity of 60.2%.
Our data indicated that CL measurements may be useful in determining patients at high risk of APH.
前置胎盘在0.3%-0.5%的妊娠中出现，并可导致产前突然大量出血（APH）。既往研究表明，经阴道超声测量的宫颈长度（CL）可能是前置胎盘患者发生APH的预测参数；然而，存在相互矛盾的数据。因此，我们研究了前置胎盘患者CL与APH之间的关联。
本研究纳入了2010年1月至2016年12月在我院分娩的129例前置胎盘单胎孕妇。分析整个孕期测量的最短CL，我们分别将CL小于或大于30mm定义为短CL或正常CL。我们进行了单因素和多因素分析，并绘制了受试者工作特征（ROC）曲线以确定预测APH的CL临界值。
26例患者发生APH。短CL患者发生APH的校正比值比为3.80（95%CI，1.36-10.65）。进行ROC分析以确定预测APH的CL临界值为35mm，敏感性为80.7%，特异性为60.2%。
我们的数据表明，测量CL可能有助于确定APH高危患者。
