Huang Yi, Li Qi, Zhang Weishe, Shen Kuifang, Zhu Jiahao, Zeng Hongtao, Lv Xiuqing, Huang Jingrui
Department of Obstetrics, Xiangya Hospital Central South University, Changsha, China.
Reproductive Medicine Center, Xiangya Hospital Central South University, Changsha, China.
Int J Med Sci. 2024 Nov 11;21(15):3010-3017. doi: 10.7150/ijms.99444. eCollection 2024.
To evaluate the predictive effect of transvaginal ultrasound measurement of cervical length and cervical elasticity examination on cervical insufficiency in twin pregnancies. Data from twin pregnant women in our hospital were collected retrospectively, including relevant vaginal ultrasound parameters (e.g., cervical length, cervical elasticity score, and the strain value of each part of the cervix). We assessed the risk factors using receiver operating characteristic curve analysis to evaluate the predictive effect of each factor on the occurrence of cervical insufficiency. A total of 284 pregnant women with twin pregnancies, including 142 with cervical insufficiency and 142 without cervical insufficiency, were included. Significant differences between the two groups were observed in the use of assisted reproductive technology, age, history of second-trimester miscarriage, etc. The cervical length of pregnant women with cervical insufficiency was significantly shorter at 22-24 weeks of gestation. Cervical length had the largest area under the receiver operating characteristic curve for predicting cervical insufficiency at that time. The area under the curve of cervical insufficiency predicted by the cervical elasticity score at 12-14 weeks of pregnancy was greater than that predicted by the cervical length at the same time, and the area under the curve of cervical insufficiency predicted by the elasticity score and pre-pregnancy body mass index during the same period was the largest. The cervical elasticity score at 12-14 weeks of gestation effectively predicted the occurrence of cervical insufficiency. The combination of the cervical elasticity score and pre-pregnancy body mass index predicted cervical insufficiency in women with twin pregnancies.
评估经阴道超声测量宫颈长度及宫颈弹性检查对双胎妊娠宫颈机能不全的预测作用。回顾性收集我院双胎妊娠孕妇的数据，包括相关阴道超声参数（如宫颈长度、宫颈弹性评分及宫颈各部位应变值）。采用受试者工作特征曲线分析评估危险因素，以评价各因素对宫颈机能不全发生的预测作用。共纳入284例双胎妊娠孕妇，其中宫颈机能不全142例，无宫颈机能不全142例。两组在辅助生殖技术使用、年龄、孕中期流产史等方面存在显著差异。宫颈机能不全孕妇在妊娠22 - 24周时宫颈长度明显较短。此时宫颈长度预测宫颈机能不全的受试者工作特征曲线下面积最大。妊娠12 - 14周时宫颈弹性评分预测宫颈机能不全的曲线下面积大于同期宫颈长度预测的曲线下面积，同期弹性评分与孕前体重指数联合预测宫颈机能不全的曲线下面积最大。妊娠12 - 14周时的宫颈弹性评分能有效预测宫颈机能不全的发生。宫颈弹性评分与孕前体重指数联合可预测双胎妊娠女性的宫颈机能不全。
