摘要
Abstract
Objective:To investigate the clinical value of cervical elasticity parameters measured by ultrasound E-cervix elastography technology combined with cervical length in evaluating cervical maturity of full-term pregnancy for predicting natural delivery.Methods:Eighty-five full-term pregnant women were randomly included.Cervical elasticity parameters,including elasticity contrast index(ECI),hardness ratio percentage(HR%),the values of internal oral strain(IOS)and external oral strain(EOS)and their ratio(IOS/EOS),and cervical length were measured by transvaginal ultrasound.85 cases were divided into the natural delivery group(32 cases),the oxytocin-induced delivery group(25 cases)and the cesarean delivery group(28 cases)according to the final delivery modes.The differences and correlations of all parameters among the three groups were compared.ROC curves based on single-parameter and multi-parameter were plotted to analyze the AUCs,sensitivities,specificities and Youden indexes corresponding to the best cut-off values in predicting natural delivery.Results:The pairwise comparisons of ECI,HR%,IOS and EOS among the three groups showed statistically significant differences(all P<0.05).The cervical length had statistically significant differences between the natural delivery group and the oxytocin-induced delivery group,and between the natural delivery group and the cesarean delivery group(both P<0.05).Single-parameter ROC curve showed that HR%had the largest AUC of 0.842,when a cut-off value of 58.651%for HR%was used,the sensitivity,specificity and Youden index were 68.8%,84.9%and 0.537,respectively.While the multi-parameter ROC curve based on HR%,EOS and cervical length showed that the combined AUC was 0.975,greater than that of each two parameters,and the sensitivity,the specificity and the Youden index were 96.9%,86.8%and 0.837,respectively.The correlation analysis showed that HR%,EOS and cervical length were independent predictors of natural delivery.Conclusions:Combining HR%,EOS and cervical length can be used as an effective quantitative indicator of assessing cervical maturity of full-term pregnancy from the change of cervical shape and texture for predicting natural delivery.关键词
宫颈弹性参数/宫颈长度/宫颈成熟度/自然分娩/超声检查Key words
Cervical elastic parameters/Cervical length/Cervical maturity/Natural delivery/Ultrasonography
