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1
How to screen the cervix and reduce the risk of spontaneous preterm birth in asymptomatic women without a prior preterm birth.如何对宫颈进行筛查并降低既往无早产史的无症状女性的自然早产风险。
Obstet Gynecol Sci. 2023 Sep;66(5):337-346. doi: 10.5468/ogs.23022. Epub 2023 Jul 13.
2
Obstetric History and Risk of Short Cervix in Women with a Prior Preterm Birth.产科史与既往早产史妇女的短宫颈风险。
Am J Perinatol. 2022 May;39(7):759-765. doi: 10.1055/s-0040-1717074. Epub 2020 Sep 24.
3
Recurrence risk of preterm births: a retrospective Indian study.早产复发风险：一项印度的回顾性研究。
J Obstet Gynaecol. 2020 Oct;40(7):925-928. doi: 10.1080/01443615.2019.1673712. Epub 2019 Dec 3.
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Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton pregnancies.宫颈环扎术联合其他治疗方法用于预防单胎妊娠自发性早产。
Cochrane Database Syst Rev. 2020 Sep 24;9(9):CD012871. doi: 10.1002/14651858.CD012871.pub2.
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Value of cervical electrical impedance spectroscopy to predict spontaneous preterm delivery in asymptomatic women: the ECCLIPPx prospective cohort study.无症状孕妇行宫颈电阻抗频谱分析预测自发性早产的价值：ECCLIPPx 前瞻性队列研究。
Ultrasound Obstet Gynecol. 2021 Aug;58(2):293-302. doi: 10.1002/uog.22180.
6
Cervical length screening for prevention of preterm birth in singleton pregnancy with threatened preterm labor: systematic review and meta-analysis of randomized controlled trials using individual patient-level data.单胎妊娠先兆早产时宫颈长度筛查预防早产：使用个体患者水平数据的随机对照试验的系统评价和荟萃分析
Ultrasound Obstet Gynecol. 2017 Mar;49(3):322-329. doi: 10.1002/uog.17388. Epub 2017 Feb 8.
7
Routine second trimester cervical length screening in low risk women identified women at risk of a 'very' preterm birth but did not reduce the preterm birth rate: a randomised study from India.一项来自印度的随机研究表明，对低风险孕妇进行常规孕中期宫颈长度筛查可识别出有“极”早产风险的孕妇，但并未降低早产率。
J Obstet Gynaecol. 2018 Aug;38(6):789-795. doi: 10.1080/01443615.2017.1419461. Epub 2018 Mar 14.
8
Prediction of preterm birth using the cervical consistency index.使用宫颈一致性指数预测早产。
Ultrasound Obstet Gynecol. 2011 Jul;38(1):44-51. doi: 10.1002/uog.9010.
9
Prevention of spontaneous preterm birth: Guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF).预防自发性早产：法国妇产科医师学会（CNGOF）临床实践指南
Eur J Obstet Gynecol Reprod Biol. 2017 Mar;210:217-224. doi: 10.1016/j.ejogrb.2016.12.035. Epub 2016 Dec 30.
10
Cerclage for sonographic short cervix in singleton gestations without prior spontaneous preterm birth: systematic review and meta-analysis of randomized controlled trials using individual patient-level data.超声检查宫颈短的单胎妊娠孕妇行环扎术以预防自发性早产史：使用个体患者水平数据的随机对照试验的系统评价和荟萃分析。
Ultrasound Obstet Gynecol. 2017 Nov;50(5):569-577. doi: 10.1002/uog.17457. Epub 2017 Oct 5.

引用本文的文献

1
Short- and Long-Term Neonatal Outcomes According to Cerclage in Nulliparous Singleton Women: A National Cohort Study Over 15 Years.未生育单胎女性宫颈环扎术的短期和长期新生儿结局：一项为期15年的全国队列研究
J Korean Med Sci. 2025 Jul 7;40(26):e131. doi: 10.3346/jkms.2025.40.e131.
2
Diabetes Mellitus as a Risk Factor for Spontaneous Preterm Birth in Women with a Short Cervix after Ultrasound-Indicated Cerclage.超声引导下宫颈环扎术后宫颈短的女性中，糖尿病作为自然早产的一个危险因素。
J Clin Med. 2024 Jun 26;13(13):3727. doi: 10.3390/jcm13133727.

本文引用的文献

1
Cervical pessary for preventing preterm birth in singleton pregnancies.宫颈托预防单胎妊娠早产。
Cochrane Database Syst Rev. 2022 Dec 1;12(12):CD014508. doi: 10.1002/14651858.CD014508.
2
Pregnancy outcomes in twin pregnancies over 10 years.10年间双胎妊娠的妊娠结局
Obstet Gynecol Sci. 2022 Jan;66(1):20-25. doi: 10.5468/ogs.22232. Epub 2022 Nov 29.
3
ISUOG Practice Guidelines: role of ultrasound in the prediction of spontaneous preterm birth.国际妇产科超声学会（ISUOG）实践指南：超声在预测自发性早产中的作用
Ultrasound Obstet Gynecol. 2022 Sep;60(3):435-456. doi: 10.1002/uog.26020. Epub 2022 Jul 29.
4
Midtrimester cervical elastography in pregnant women with a history of loop electrosurgical excision procedure (LEEP).经阴道环行电切术（LEEP）史孕妇的中孕期宫颈弹性成像。
Sci Rep. 2022 Jun 2;12(1):9191. doi: 10.1038/s41598-022-13170-9.
5
ISUOG Practice Guidelines (updated): performance of the routine mid-trimester fetal ultrasound scan.国际妇产科超声学会（ISUOG）实践指南（更新版）：孕中期常规胎儿超声检查的实施
Ultrasound Obstet Gynecol. 2022 Jun;59(6):840-856. doi: 10.1002/uog.24888. Epub 2022 May 20.
6
Screening for spontaneous preterm birth by cervical length and shear-wave elastography in the first trimester of pregnancy.通过宫颈长度和妊娠早期的剪切波弹性成像筛查自发性早产。
Am J Obstet Gynecol. 2022 Sep;227(3):500.e1-500.e14. doi: 10.1016/j.ajog.2022.04.014. Epub 2022 Apr 20.
7
Medical Utilization and Costs in Preterm Infants in the First 6 Years of Life After Discharge From Neonatal Intensive Care Unit: A Nationwide Population-Based Study in Korea.早产儿在离开新生儿重症监护病房后 6 年内的医疗利用和费用：韩国全国基于人群的研究。
J Korean Med Sci. 2022 Mar 28;37(12):e93. doi: 10.3346/jkms.2022.37.e93.
8
Shear wave elastography: the relationship of the cervical stiffness with gestational age and cervical length- a feasibility study.剪切波弹性成像：宫颈硬度与孕周及宫颈长度的关系——一项可行性研究
J Matern Fetal Neonatal Med. 2022 Dec;35(25):9684-9693. doi: 10.1080/14767058.2022.2050896. Epub 2022 Mar 25.
9
Transperineal ultrasound in routine uterine cervix measurement.经会阴超声在常规子宫颈测量中的应用。
Arch Gynecol Obstet. 2023 Feb;307(2):387-393. doi: 10.1007/s00404-022-06521-4. Epub 2022 Mar 23.
10
Interventions to prevent spontaneous preterm birth in women with singleton pregnancy who are at high risk: systematic review and network meta-analysis.干预措施以预防高危单胎妊娠妇女自发性早产：系统评价和网络荟萃分析。
BMJ. 2022 Feb 15;376:e064547. doi: 10.1136/bmj-2021-064547.

如何对宫颈进行筛查并降低既往无早产史的无症状女性的自然早产风险。

How to screen the cervix and reduce the risk of spontaneous preterm birth in asymptomatic women without a prior preterm birth.

作者信息

Lee Seon Ui, Jung Gyul, Kim Han Wool, Ko Hyun Sun

机构信息

Department of Obstetrics and Gynecology, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Korea.

出版信息

Obstet Gynecol Sci. 2023 Sep;66(5):337-346. doi: 10.5468/ogs.23022. Epub 2023 Jul 13.

DOI:10.5468/ogs.23022
PMID:37439085
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10514583/
Abstract

Preterm birth (PTB) is a leading cause of perinatal morbidity and mortality globally. PTB rates have increased in South Korea despite reduction in birth rates. A history of PTB is a strong predictor of subsequent PTB and screening of cervical length between 16 0/7 weeks and 24 0/7 weeks of gestation is recommended in women with a singleton pregnancy and a prior spontaneous PTB. However, the prediction and prevention of spontaneous PTBs in women without a prior PTB remain a matter of debate. The scope of this review article comprises cervical screening and prevention strategies for PTB in asymptomatic women without a prior PTB, based on recent evidence and guidelines.

摘要

早产是全球围产期发病和死亡的主要原因。尽管韩国的出生率有所下降，但早产率仍在上升。早产史是后续早产的有力预测指标，对于单胎妊娠且有自发早产史的女性，建议在妊娠16 0/7周至24 0/7周之间筛查宫颈长度。然而，对于无早产史女性的自发早产的预测和预防仍存在争议。基于近期的证据和指南，本文综述的范围包括对无早产史无症状女性的早产宫颈筛查和预防策略。