摘要
目的探讨超声弹性成像评估足月妊娠宫颈预测临产时间的临床价值。方法回顾性选取2021年11月至2022年12月在大连医科大学附属第二医院产科病房住院的符合纳入标准的足月妊娠孕妇85例。采用统计学方法分析足月后,经阴道超声评估宫颈各参数(宫颈的长度、相同面积下宫颈内口与宫颈外口的应变率及两者的比值)的时间与孕妇临产时间之间的时间差定义为距离临产时间(TOL),将85例孕妇分为TOL<7 d组(n=27)和TOL≥7 d(n=58)。记录85例孕妇的基本资料,宫颈的长度、相同面积下宫颈内口与宫颈外口弹性应变率及两者的比值,分析TOL的影响因素;比较TOL<7 d组与TOL≥7 d组的宫颈长度、宫颈位置、相同面积下宫颈内、外口弹性应变率及两者的比值,分析TOL<7 d组与TOL≥7 d组的影响因素;并对TOL≥7 d组内的宫颈长度、宫颈位置、相同面积下宫颈内、外口弹性应变率及两者的比值进行Logistic回归分析。结果足月妊娠后,受检孕妇TOL四分位组基本特征比较可得,无论是TOL≥7 d组,还是TOL<7 d组,孕妇的孕周(P=0.001)和宫颈长度(P=0.023)是预测临产时间的相关因素;宫颈内口弹性应变率、宫颈外口弹性应变率以及两者的比值预测临产时间差异无统计学意义(P>0.05)。TOL<7 d组宫颈长度为(24.10±5.48)mm,明显小于TOL≥7 d组[(28.30±4.80)mm],宫颈内口弹性应变率为0.22±0.06,明显大于TOL≥7 d组(0.19±0.04),差异均有统计学意义(P<0.05),但TOL<7 d组与TOL≥7 d组的年龄、孕周、身高、体重指数、宫颈外口弹性应变率及宫颈外口与宫颈内口弹性应变率比值比较,差异均无统计学意义(P>0.05)。TOL≥7 d组Logistic回归分析结果显示,孕周小、宫颈外口弹性应变率大,宫颈外口与宫颈内口弹性应变率比值大,更是TOL>10 d的危险因素(P<0.05)。结论孕周和宫颈长度对于TOL有影响;TOL≥7 d者宫颈外口与内口变化率比值越大,宫颈内口弹性
Objective To investigate the clinical value of ultrasound elastography in predicting the time of labor in the cervix of full-term pregnancy.Methods A total of 85 full-term pregnant women who met the inclusion criteria and were hospitalized in the obstetrics ward of the Second Affiliated Hospital of Dalian Medical University between November 2021 and December 2022 were retrospectively selected.Statistical analysis was conducted after delivery,with time to onset of labor(TOL)defined as the time difference between cervical parameters evaluated by transvaginal ultrasound(cervical length,strain rate,and ratio of internal and external cervical openings under the same area)and labor onset.The 85 pregnant women were divided into TOL<7 d group(n=27)and TOL≥7 d group(n=58).Basic data on pregnant women in 85 full-term pregnant women were recorded,including cervical length,strain rate,ratio of inner/outer cervix under same area;influencing factors on TOL were analyzed accordingly.Cervical length,position,elastic strain rate at inner/outer cervical orifices under same area as well as their ratios between two groups(TOL<7 d vs.TOL≥7 d)were compared;influencing factors on these parameters also examined through logistic regression.Results After full-term pregnancy,the basic characteristics of the TOL quartile group of the pregnant women under examination were compared.Regardless of whether it was the TOL≥7 d group or the TOL<7 d group,there were statistically significant differences in gestational age(P=0.001)and cervical length(P=0.023)for predicting labor duration;the elastic strain rate of both the inner and outer cervical openings,as well as their ratio,did not show any statistical difference in predicting labor duration(P>0.05).The cervical length of the TOL<7 d group was(24.10±5.48)mm,which was significantly smaller than that of the TOL≥7 d group[(28.30±4.80)mm],the elastic strain rate of the cervical opening was 0.22±0.06,which was significantly higher than that of the TOL≥7 d group(0.19±0.04),and the differ
作者
沙恩波
周桥
丁千
荆春丽
SHA En-bo;ZHOU Qiao;DING Qian(Department of Obstetrics and Gynecology Ultrasound Imaging,the Second Affiliated Hospital of Dalian Medical University,Dalian Liaoning 116000,China)
出处
《临床和实验医学杂志》
2024年第6期651-655,共5页
Journal of Clinical and Experimental Medicine
基金
辽宁省卫生和计划生育委员会科研课题(编号:21FP9168)。
关键词
妊娠
子宫颈
预测
超声弹性成像
应变率
临产时间
Pregnancy
Cervix uteris
Prediction
Ultrasound elastic imaging
Strain rate
Time to onset of labor
