Cabrol D, Grangé G
Maternité Port-Royal-Baudelocque, Paris.
J Gynecol Obstet Biol Reprod (Paris). 1998 Apr;27(3):259-64.
Uterine cervical modifications play a central role in preterm labor and are one of the main indicators for the clinical diagnosis of this syndrome. Modifications of the cervix are either isolated events "cervical incompetence" or associated with cervicovaginal infection, which is an important etiological factor. Furthermore, the extent of cervical modifications in preterm labor is probably related to the prognosis of preterm delivery. Certain developments in the treatment of preterm pregnancy have focused on the uterine cervix (e.g. cervical cerclage, treatment of cervicovaginal infections) and such strategies may facilitate the prevention of preterm delivery. The information currently available emphasizes an independent role for the uterine cervix in preterm labor. As a consequence, it should be realised that even though there is a direct association between cervical modifications and uterine contractions, management of preterm labour must not be directed exclusively at the control of uterine contractions and tocolysis.
子宫颈改变在早产中起核心作用,是该综合征临床诊断的主要指标之一。宫颈改变要么是孤立事件(“宫颈机能不全”),要么与宫颈阴道感染相关,而宫颈阴道感染是一个重要的病因因素。此外,早产时宫颈改变的程度可能与早产的预后有关。早产治疗的某些进展集中在子宫颈(如宫颈环扎术、宫颈阴道感染的治疗),此类策略可能有助于预防早产。目前可得的信息强调子宫颈在早产中具有独立作用。因此,应该认识到,尽管宫颈改变与子宫收缩之间存在直接关联,但早产的管理绝不能仅针对子宫收缩的控制和宫缩抑制。