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目的探讨经会阴超声下宫颈管长度、宫颈内口扩张程度及前羊膜囊嵌入宫颈管内的程度(HM)对预测先兆早产保胎治疗效果的临床意义。方法测量正常孕妇及先兆早产孕妇的宫颈管长度、内口扩张程度、HM,并随访其妊娠结局。结果 30例先兆早产孕妇中,宫颈管平均长度为(26.46±2.77)mm,显著短于正常组的(35.87±2.77)mm(P<0.001);随着宫颈管长度及HM分值的增加,早产发生率明显增高,其中以x-2s(31mm)的颈管长度作为临界值,其敏感度为100%,特异度为70.6%,阳性预测值为72.2%,阴性预测值为100%。结论经会阴超声下宫颈管长度及HM对预测先兆早产保胎治疗效果有一定的指导意义。
Objective To investigate the clinical significance of predicting the prognosis of threatened preterm labor by transperineal ultrasonography, including the length of cervical canal, the degree of cervical internal ostia expansion, and the extent of anterior amniotic membrane embedding into the cervical canal (HM). Methods The cervical canal length, the extent of internal ostia, HM, and the pregnancy outcome of normal pregnant women and threatened premature pregnant women were measured. Results The average length of cervical canal was (26.46 ± 2.77) mm in 30 pregnant women with preeclampsia, which was significantly shorter than that in normal group (35.87 ± 2.77) mm (P <0.001). With the increase of cervical canal length and HM score, The incidence of preterm delivery was significantly higher. The sensitivity and specificity of the neck length of x-2s (31mm) were 100%, 70.6%, 72.2% and 100%, respectively. Conclusions Trans-perineal ultrasonography of cervical canal length and HM can predict the effect of preterm labor on tocolysis.