现代妇产科进展2018，Vol.27Issue(1)：37-40,4.DOI:10.13283/j.cnki.xdfckjz.2018.01.009
孕期宫颈长度在前置胎盘紧急剖宫产中的预测价值
The clinical value of cervical length to predict emergency cesarean section during preg-nancy in placenta previa woman
李亚妮 1肖景华 1王艳霞 1许欣1
作者信息
- 1. 西北妇女儿童医院妇产科,西安 710061
- 折叠
摘要
Abstract
Objective:To assess whether the CL changes over time could be used as a predictor of emergency CS in placenta previa woman. Methods:93 placenta previa were retro-spectively analyzed in Obstetrics and Gynecology Department of our hospital from Jan. 2010 to Nov. 2014. Cervical length were measured through transvaginal ultrasound in different gesta-tion,respectively divided into CL1(19 to 23 weeks of gestation),CL2(24 to 28 weeks of gesta-tion),CL3(29 to 31 weeks of gestation) and CL4(32 to 34 weeks of gestation). 31 underwent emergency CS for vaginal hemorrhage,and 63 others underwent selective CS. The clinical data, CL changes and clinical outcomes of the two groups were compared. The risk factors and the predictive value of CL changes in emergency CS of placenta previa woman were analyzed. Re-sults:CL tended to decrease with advancing gestational age in each group. Until 29～31 weeks, CL showed no significant differences between the two groups. After 32 weeks,CL in the emer-gency CS group decreased abruptly,while CL in the elective CS group continued to gradually decrease. On multivariate analysis to determine risk factors,only admissions for bleeding( OR=34. 710,95％CI 5. 239～229. 973) and change in CL(OR=3. 522,95％CI 1. 210～10. 253) were significantly associated with emergency CS. Analysis of the receiver operating characteristic curve showed that change in CL could be the predictor of emergency CS( area under the curve 0. 734,P<0. 001),with optimal cutoff for predicting emergency cesarean delivery of 6. 0mm. Conclusion:Admission vaginal bleeding and CL changes were independent predictors of emer-gency CS in placenta previa woman. The CL change more than 6mm between second and third trimester shows high risk of emergency CS in placenta previa woman,while a single time short-ening could not predict emergency CS.关键词
宫颈长度/阴道超声/前置胎盘/紧急剖宫产/预测Key words
Cervical length/Transvaginal ultrasound/Placenta previa/Emergency ce-sarean section/Prediction分类
医药卫生引用本文复制引用
李亚妮,肖景华,王艳霞,许欣..孕期宫颈长度在前置胎盘紧急剖宫产中的预测价值[J].现代妇产科进展,2018,27(1):37-40,4.
