Goffinet F, Rozenberg P, Kayem G, Perdu M, Philippe H J, Nisand I
Service de Gynécologie et Obstétrique, Centre Hospitalier Intercommunal, Poissy.
J Gynecol Obstet Biol Reprod (Paris). 1997;26(6):623-9.
To determinate the predictive value of cervical length, measured by transvaginal ultrasound, for preterm delivery among patients with signs of preterm labor.
Department of Gynecology & Obstetrics, Poissy Hospital Center.
A prospective study that measured cervical length by transvaginal ultrasound was performed among 108 patients with a singleton pregnancy hospitalized with signs of premature labor between 24 and 34 weeks' gestation or within 21 days of inclusion.
The rate of preterm birth was 22.2% (24/108). When cervical length was < or = 26 mm, the gestational age at delivery was significantly lower that when it exceeded 26 mm (36.3 +/- 3.0 weeks compared with 38.5 +/- 2.1 weeks; p < 0.0001). 40.4% (19/47) of patients whose cervical length was < or = 26 mm gave birth prematurely, compared with only 8.2% (5/61) of those with a cervix > 26 mm The sensitivity, specificity, positive predictive value, and negative predictive value of transvaginal ultrasonography were, respectively, 79.2, 66.6, 40.4, and 91.8% for delivery before 37 weeks' gestation, and 75.0, 62.0, 25.5, and 93.4% for delivery within 21 days of the ultra-sound measurement.
Transvaginal ultrasound of the cervix provides an objective method for evaluating the risk of preterm delivery. Its predictive values are impressive and allow better discrimination between women at high risk of preterm delivery and those in false preterm labor.
确定经阴道超声测量的宫颈长度对早产迹象患者早产的预测价值。
普瓦西医院中心妇产科。
对108例单胎妊娠、孕周在24至34周之间或纳入研究后21天内因早产迹象住院的患者进行了一项前瞻性研究，通过经阴道超声测量宫颈长度。
早产率为22.2%（24/108）。当宫颈长度≤26mm时，分娩时的孕周显著低于宫颈长度超过26mm时（分别为36.3±3.0周和38.5±2.1周；p<0.0001）。宫颈长度≤26mm的患者中有40.4%（19/47）早产，而宫颈长度>26mm的患者中只有8.2%（5/61）早产。经阴道超声检查对于妊娠37周前分娩的敏感性、特异性、阳性预测值和阴性预测值分别为79.2%、66.6%、40.4%和91.8%，对于超声测量后21天内分娩的敏感性、特异性、阳性预测值和阴性预测值分别为75.0%、62.0%、25.5%和93.4%。
经阴道超声检查宫颈为评估早产风险提供了一种客观方法。其预测价值令人印象深刻，能够更好地区分早产高危女性和假性早产女性。
