摘要
目的纵向研究早产低危孕妇宫颈长度的孕期变化和胎儿纤连蛋白的状况,为早产预测奠定基础。方法对单胎无早产高危因素和无任何妊娠合并症和严重并发症的初产妇,分别纵向在妊娠22-24周、26-28周、30-32周行后穹隆分泌物胎儿纤连蛋白测定、阴道超声检测宫颈,测量宫颈长度,追踪妊娠结局。结果①共30例完成3个孕期的全部检查,22-24周、26-28周和30-32周胎儿纤连蛋白阳性率分别为：6.7%（2/30）、20.0%（6/30）、16.7%（5/30）;26-28周和30-32周胎儿纤连蛋白阳性者有3例患有阴道炎症;②22-24周、26-28周和30-32周宫颈长度分别为：（3.81±0.26）cm、（3.80±0.36）cm、（3.58±0.32）cm,30-32周的宫颈长度显著短于22-24周和26-28周（P〈0.05）;③30例孕妇中1例在34周发生早产,早产率为3.3%,其胎儿纤连蛋白在26周和31周的检测均为阳性,但宫颈长度正常。其余病历均足月分娩;④1例在30周时宫颈长度为2.7 cm,宫颈长度缩短（〈3.0 cm）的比例为3.3%,该例胎儿纤连蛋白（-）,并且未发生早产。结论早产低危孕妇宫颈长度在30周后有轻微改变;胎儿纤维连接蛋白测定显示出一定比例的假阳性的存在,胎儿纤连蛋白的假阳性可能与阴道炎有关,并有待于进一步研究。
Objective To longitudinally investigate the cervical length and expression of the fetal fibronectin（fFN） in women of 22-32 gestational weeks.Methods Thirty pregnancy women without any high risk factors for preterm birth or other obstetrical complications underwent examination of fFN and measurement of cervical length using the transvaginal sonography at 22-24,26-28 and 30-32 weeks of gestation respectively.The outcomes of pregnancy were followed up.Results ① The fFN（＋） rate at 22-24,26-28 and 30-32 weeks of gestation were 6.7%（2/30）,20.0%（6/30） and 16.7%（5/30）,respectively.Among the fFN（＋） women three of them presented vaginal inflammation at 26-28 and 30-32 weeks of gestation.② The cervical length at 22-24,26-28 and 30-32 weeks of gestation were（3.81±0.26） cm,（3.80±0.36） cm and（3.58±0.32） cm.The cervical length at 30-32 weeks were significantly shorter than at 22-24 or 26-28 weeks（P〈0.05）.③ Only one women with fFN（＋） and normal cervical length delivered prematurely at 34 weeks of gestation,and the incidence of preterm birth was 3.3%.④ Only one showed cervical length shorter than 3.0 cm at 30 weeks of gestation,and the incidence of abnormal cervical length was 3.3%.She delivered her baby termly and showed negative fFN.ConclusionsThe cervical length among the normal pregnancy women with low risk factor for preterm birth has a mild change after 30 weeks of gestation.Whether the high false positive rate of fFN is associated with different vaginal inflammation needs more studies.
出处
《中国妇产科临床杂志》
2008年第6期412-414,共3页
Chinese Journal of Clinical Obstetrics and Gynecology
基金
北京市科学技术委员会重大项目培育专项(20005190000091)资助
关键词
阴道超声检查
宫颈长度
胎儿纤连蛋白
早产预测
纵向研究
vaginal ultrasonography
cervical length
fetal fibronectin
prediction for preterm delivery
longitudinal study
