Melchor Corcóstegui Iñigo, Unibaso Rodríguez Estíbaliz, Ruiz Blanco Nagore, Nikolova Tanja, Nikolova Natasha, Burgos San Cristóbal Jorge, Melchor Marcos Juan Carlos
Department of Obstetrics and Gynecology, BioCruces Health Research Institute, Cruces University Hospital (UPV/EHU), Vizcaya, Spain.
Department of Obstetrics and Gynecology, Klinikum Mittelbaden Baden-Baden, Academic Teaching Hospital of Heidelberg University, Germany.
Taiwan J Obstet Gynecol. 2023 May;62(3):412-416. doi: 10.1016/j.tjog.2022.09.014.
To assess the incidence of threatened preterm labor and preterm labor admissions and treatment of women with singleton gestations and no prior preterm birth before and after implementation of the universal mid-trimester transvaginal ultrasound cervical length screening.
A retrospective cohort study included of singleton gestations without a history of preterm birth presenting with threatened preterm labor between 24 0/7 and 36 6/7 gestational week in two study periods: before and after the implementation of the universal cervical length screening. Women with cervical length <25 mm were considered being at high risk for preterm birth and were prescribed a treatment with vaginal progesterone daily. The primary outcome was the incidence of threatened preterm labor. Secondary outcomes were the incidence of preterm labor.
We have found a significant increase in the incidence of threatened preterm labor from 6.42% (410/6378) in 2011 to 11.61% (483/4158) in 2018 (p < 0.0001). Gestational age at triage consult was lower in than in 2011, although the rate of admission for threatened preterm labor was similar in both periods. There was a significant decrease in the incidence of preterm delivery <37 weeks from 25.60% in 2011 to 15.94% in 2018 (p < 0.0004). Although there was a reduction in preterm delivery ≤34 weeks, this reduction was not significant.
The universal mid-trimester cervical length screening in asymptomatic women is not associated with a reduction in the frequency of threatened preterm labor or the admission rate for preterm labor, but reduces the rate of preterm births.
评估在实施孕中期经阴道超声宫颈长度普遍筛查前后，单胎妊娠且既往无早产史的孕妇发生先兆早产及早产入院和治疗的发生率。
一项回顾性队列研究纳入了两个研究阶段（实施宫颈长度普遍筛查前后）中孕24⁰/₇至36⁶/₇孕周出现先兆早产的无早产史单胎妊娠孕妇。宫颈长度<25mm的孕妇被认为早产风险高，每日给予阴道用黄体酮治疗。主要结局是先兆早产的发生率。次要结局是早产的发生率。
我们发现先兆早产的发生率从2011年的6.42%（410/6378）显著增加至2018年的11.61%（483/4158）（p<0.0001）。尽管两个时期先兆早产的入院率相似，但2018年分诊咨询时的孕周低于2011年。<37周早产的发生率从2011年的25.60%显著降至2018年的15.94%（p<0.0004）。虽然≤34周早产有所减少，但这种减少不显著。
对无症状孕妇进行孕中期宫颈长度普遍筛查与先兆早产频率或早产入院率的降低无关，但可降低早产率。
