Department of Obstetrics and Gynecology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Department of Obstetrics and Gynecology, Sichuan Jinxin Women's and Children's Hospital, Chengdu, Sichuan, China.
Technol Health Care. 2024;32(6):3815-3827. doi: 10.3233/THC-240079.
Pregnancy is an important process in women's life, which is widely concerned by women. In recent years, the incidence of premature delivery (PTD) becomes more and more higher due to the development of auxiliary reproduction and ovulation induction technologies and the changes of pregnant women's lifestyle and physical quality. PTD not only affects postpartum recovery and causes great physical pains, but it also has adverse effects on the birth state of neonates and even leads to neonatal death.
The predictive values of cervix length (CL) measurement based on transvaginal ultrasonography (TVUS) and pathological examination of placenta for premature delivery (PTD) were investigated and the correlation between PTD and infection was analyzed.
120 pregnant women with PTD or high-risk factors for PTD admitted to The Affiliated Hospital of Southwest Medical University between February 2020 and March 2022 were included as the subjects and underwent pathological examination of placenta and TVUS for CL measurement. The final gestational age was set as the standard for the evaluation on the predictive values of pathological examination of placenta and TVUS. What's more, 36 subjects in PTD group and 84 in normal delivery group (control group) underwent pathological examination of placenta for the analysis of the correlation between PTD and infection.
The joint inspection method showed significantly better sensitivity, specificity, PPV, and NPV compared to single CL or pathological examination of the placenta (P< 0.05). Among pregnant women, those with CL ⩽ 30 mm and positive placental pathology had a higher proportion compared to those with CL > 30 mm and negative placental pathology (P< 0.05). Furthermore, the incidence of Ureaplasma Urealyticum (UU), Chlamydia Trachomatis (CT), and Chorioamnionitis (CA) in vaginal discharge of the preterm delivery (PTD) group was significantly higher than that of the control group (P< 0.05).
The combination of CL ⩽ 30 mm and positive placental pathology could effectively predict PTD and placental infection was notably correlated with the occurrence of PTD.
妊娠是女性生命中的一个重要过程，备受女性关注。近年来，由于辅助生殖和排卵诱导技术的发展以及孕妇生活方式和体质的变化，早产（PTD）的发生率越来越高。PTD 不仅影响产后恢复，给产妇带来巨大的身体痛苦，而且对新生儿的出生状况也有不良影响，甚至导致新生儿死亡。
探讨经阴道超声（TVUS）测量宫颈长度（CL）和胎盘病理检查对早产（PTD）的预测价值，并分析 PTD 与感染的相关性。
选取 2020 年 2 月至 2022 年 3 月西南医科大学附属医院收治的 120 例 PTD 或 PTD 高危孕妇为研究对象，进行胎盘病理检查和 TVUS 测量 CL。以最终妊娠龄为标准，评价胎盘病理检查和 TVUS 的预测价值。另外，在 PTD 组中选择 36 例，在正常分娩组（对照组）中选择 84 例进行胎盘病理检查，分析 PTD 与感染的相关性。
联合检查方法的灵敏度、特异度、PPV 和 NPV 均明显优于单独 CL 或胎盘病理检查（P<0.05）。在孕妇中，CL ⩽30mm 且胎盘病理阳性者的比例明显高于 CL>30mm 且胎盘病理阴性者（P<0.05）。此外，早产（PTD）组阴道分泌物中解脲脲原体（UU）、沙眼衣原体（CT）和绒毛膜羊膜炎（CA）的检出率明显高于对照组（P<0.05）。
CL ⩽30mm 联合胎盘病理阳性可有效预测 PTD，且胎盘感染与 PTD 的发生显著相关。
