论文部分内容阅读
目的:探讨子宫颈管长度的测量对前置胎盘提早剖宫产的预测价值。方法:回顾分析103例前置胎盘孕妇,根据孕晚期阴道超声测量子宫颈管长度将患者分为两组:观察组(宫颈长度≤25mm)及对照组(宫颈长度>25mm),比较两组的妊娠结局,并绘制子宫颈管长度预测前置胎盘孕36周前提早剖宫产的ROC曲线,计算曲线下面积和最佳临界点。结果:观察组患者产前出血时的孕周和分娩时孕周均明显短于对照组,差异均有统计学意义(P<0.05)。观察组孕妇的产前出血、早产、孕36周前的剖宫产发生率明显高于对照组,差异有统计学意义(P<0.001),新生儿出生体重及5min Apgar评分低于对照组,转儿科治疗率上明显高于对照组,差异均有统计学意义(P<0.001);两组的输血、新生儿窒息方面差异无统计学意义(P>0.05)。以宫颈长度25mm作为发生孕36周前提早剖宫产的预测值,其敏感度为83.6%,特异度为78.3%,ROC曲线下面积85.5%。根据ROC曲线分析得出预测提早剖宫产的宫颈长度最佳阈值为26.5mm。结论:阴道超声测量前置胎盘孕妇子宫颈管长度可作为预测其紧急提早剖宫产发生的一种方法,从而加强干预管理,避免严重的围产期并发症发生。
Objective: To investigate the predictive value of cervical canal length for early cesarean section of placenta previa. Methods: A total of 103 pregnant women with placenta previa were retrospectively analyzed. The patients were divided into two groups according to the length of the cervical canal during the second trimester of pregnancy: the observation group (cervical length ≤ 25 mm) and the control group (cervical length> 25 mm) Pregnancy outcome, and draw the length of the cervical canal predict the pre-placenta premature pregnancy 36 weeks before the cesarean section ROC curve to calculate the area under the curve and the best critical point. Results: The gestational age and gestational age at delivery in the observation group were significantly shorter than those in the control group (P <0.05). The incidence of cesarean section in the pregnant women in the observation group was significantly higher than that in the control group (P <0.001). The neonatal birth weight and Apgar score at 5 minutes were lower than those in the control group The treatment rate of pediatric patients was significantly higher than that of the control group (P <0.001). There was no significant difference between the two groups in blood transfusion and neonatal asphyxia (P> 0.05). The cervical length of 25mm was used as the predictor of early cesarean section 36 weeks before pregnancy, with a sensitivity of 83.6%, a specificity of 78.3% and an area under the ROC curve of 85.5%. According to the ROC curve analysis, the optimal threshold of cervical length predicted by early cesarean section was 26.5 mm. CONCLUSIONS: Vaginal ultrasound measurement of cervical canal length in the placenta previa can be used as a method to predict the emergency cesarean section, so as to strengthen the intervention management and avoid the serious perinatal complications.