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外科研究与新技术 ›› 2021, Vol. 10 ›› Issue (2): 113-116.doi: 10.3969/j.issn.2095-378X.2021.02.010

• 论著 • 上一篇    下一篇

超声弹性成像评估宫颈成熟度预测临产时间的研究

戴萌, 王秀艳   

  1. 同济大学附属同济医院超声科,上海 200065
  • 收稿日期:2020-11-25 出版日期:2021-06-28 发布日期:2022-08-22
  • 通讯作者: 王秀艳,电子信箱:tjwangxiuyan@163.com
  • 作者简介:戴萌(1989—),女,大学本科,医师,从事临床超声科工作

Prediction of expected date of confinement by cervical maturity evaluated by ultrasound elastography

DAI Meng, WANG Xiuyan   

  1. Department of Ultrasound, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, China
  • Received:2020-11-25 Online:2021-06-28 Published:2022-08-22

摘要: 目的 研究超声弹性成像评估宫颈成熟度对临产时间的预测。方法 选取符合要求的孕晚期孕妇共176例,根据距离临产时间(TOL)将研究对象分为两组。TOL≤1周组96例、TOL>1周组80例。通过腹部超声和弹性成像功能记录两组患者的一般资料、宫颈长度、宫颈宽度、胎先露高度、羊膜腔嵌入宫颈内口级别、B/A值。利用单因素分析找出影响临产时间的指标,再利用多因素logistic回归分析找出预测临产的独立影响因子,并利用ROC曲线分析其对临产时间的预测价值。结果 宫颈长度、胎先露高度、B/A值是预测临产的独立影响因子(P<0.05)。宫颈长度、胎先露高度、B/A值以及3个指标联合在ROC曲线下面积分别为0.740、0.743、0.817、0.903。经比较,3个指标联合的AUC最高,其次为B/A值,宫颈长度与胎先露高度相对较低。B/A值预测临产的最佳诊断点为1.325,灵敏度为50%,特异度为95.8%;三者联合诊断的灵敏度为98.8%,特异度为62.5%。结论 B/A值可作为预测临产的指标之一,与宫颈长度和胎先露高度联合可提高预测临产时间的准确性,为临床预测临产时间提供指导。

关键词: 超声弹性成像, 宫颈成熟度, 临产时间, B/A值

Abstract: Objective To study the prediction of expected date of confinement by cervical maturity evaluated by ultrasound elastography. Methods A total of 176 pregnant women who met the inclusion requirements were divided into two groups according to the time to onset of labor (TOL), TOL ≤ 1 week group (96 cases) and TOL>1 week group (80 cases). The general data, cervical length, cervical width, height of fetal exposure, depth of embedded amniotic cavity, and B/A value of two groups were recorded by abdominal ultrasound and elastography. Univariate analysis was used to find out the indicators that affect the TOL. Multiple logistic analysis was used to identify independent influencing factors for TOL. ROC curve was used to analyze the potential prediction efficiency of each index. Results Cervical length, height of fetal exposure, and B/A value were independent influencing factors for predicting TOL (P<0.05). The area under curve (AUC) of cervical length, height of fetal exposure, B/A value, and their combination were 0.740, 0.743, 0.817, and 0.903, respectively. The AUC of the combination of the three indicators was the highest, followed by B/A value, while height of fetal exposure and cervical length were the lowest in AUC. The best diagnosis point for TOL of B/A value was 1.325, the sensitivity was 50%, and the specificity was 95.8%. The sensitivity of the combination was 98.8%, and the specificity was 62.5%. Conclusion B/A value could be used as one of the indicators for predicting TOL, and the combination of cervical length, height of fetal exposure, and B/A value could improve the accuracy of the prediction, and provide guidance for clinical labor prediction.

Key words: Ultrasound elastography, Cervical maturity, Time to onset of labor, B/A value

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