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中华医学超声杂志(电子版) ›› 2021, Vol. 18 ›› Issue (05) : 501 -507. doi: 10.3877/cma.j.issn.1672-6448.2021.05.011

所属专题: 产前超声 文献 妇产科超声

综述

超声评估宫颈预测早产的新进展
陈海霞1, 文华轩1, 李胜利1,()   
  1. 1. 518028 南方医科大学附属深圳妇幼保健院超声科
  • 收稿日期:2020-03-27 出版日期:2021-05-01
  • 通信作者: 李胜利
  • 基金资助:
    国家重点研发计划(2018YFC1002202); 国家自然科学基金(81771598); 深圳市科技计划项目(JCYJ20170307091013214)

Progress in prediction of preterm birth by ultrasound cervical measurement

Haixia Chen1, Huaxuan Wen1, Shengli Li1()   

  • Received:2020-03-27 Published:2021-05-01
  • Corresponding author: Shengli Li
引用本文:

陈海霞, 文华轩, 李胜利. 超声评估宫颈预测早产的新进展[J]. 中华医学超声杂志(电子版), 2021, 18(05): 501-507.

Haixia Chen, Huaxuan Wen, Shengli Li. Progress in prediction of preterm birth by ultrasound cervical measurement[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(05): 501-507.

图1 子宫颈的解剖结构。图a 为子宫冠状断面;图b 为子宫矢状断面
图2~4 孕妇宫颈超声测量声像图。图2 孕妇,26岁,孕18周,经腹部超声测量图;图3 孕妇,30岁,孕22周,经会阴超声测量图;图4 孕妇,27岁,孕20周,经阴道超声测量图
图5 宫颈漏斗形成超声示意图(经阴道超声)。 图a、b、c、d分别为宫颈形态呈“T”、“Y”、“V”、“U”变化,宫颈内口异常扩张过程中,宫颈形状由“T”→“Y”→“V”→“U”逐渐转变
图6 经阴道超声标准测量宫颈长度示意图。图a 显示较平直的宫颈管,使用直线一步测量法;图b 显示有弯曲的宫颈管(A),使用直线两步测量法
图7 宫颈环扎术后经阴道超声检查宫颈示意图。图a 宫颈内口呈开放状态,可见强回声环扎线(白箭头所示);图b 宫颈内口呈闭合状态,可见强回声环扎线(红箭头所示)
1
Blencowe H, Cousens S, Oestergaard MZ, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications [J]. Lancet, 2012, 379(9832): 2162-2172.
2
张小松, 赵更力, 杨慧霞, 等. 15家城市医疗机构早产发生情况及影响因素分析 [J].中华围产医学杂志, 2016, 19(6): 456-461.
3
郑倩文, 郭珊珊, 刘继红. 宫颈重塑与早产相关性的研究进展 [J]. 现代妇产科进展, 2019, 28(6): 475-476.
4
中华医学会妇产科学分会产科学组. 早产临床诊断与治疗指南(2014) [J]. 中华妇产科杂志, 2014, 49(7): 481-485.
5
王文第, 陈亚, 张春花, 等. 母亲不良孕产史对早产发生的影响 [J]. 中国优生与遗传杂志, 2016, 24(9): 56-59.
6
McManemy J, Cooke E, Amon E, et al. Recurrence risk for preterm delivery [J]. Am J Obstet Gynecol, 2007, 196(6): 576. e1-6; discussion 576. e6-7.
7
Myers KM, Elad D. Biomechanics of the human uterus [J]. Wiley Interdiscip Rev Syst Biol Med, 2017, 9(5): e1388.
8
Vink J, Myers K. Cervical alterations in pregnancy [J]. Best Pract Res Clin Obstet Gynaecol, 2018, 52: 88-102.
9
Iams JD, Goldenberg RL, Meis PJ, et al. The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network [J]. N Engl J Med, 1996, 334(9): 567-572.
10
Silva SV, Damião R, Fonseca EB, et al. Reference ranges for cervical length by transvaginal scan in singleton pregnancies [J]. J Matern Fetal Neonatal Med, 2010, 23(5): 379-382.
11
To MS, Fonseca EB, Molina FS, et al. Maternal characteristics and cervical length in the prediction of spontaneous early preterm delivery in twins [J]. Am J Obstet Gynecol, 2006, 194(5): 1360-1365.
12
van de Mheen L, Schuit E, Lim AC, et al. Prediction of preterm birth in multiple pregnancies: development of a multivariable model including cervical length measurement at 16 to 21 weeks′ gestation [J]. J Obstet Gynaecol Can, 2014, 36(4): 309-319.
13
Skentou C, Souka AP, To MS, et al. Prediction of preterm delivery in twins by cervical assessment at 23 weeks [J]. Ultrasound Obstet Gynecol, 2001, 17(1): 7-10.
14
Hernandez-Andrade E, Romero R, Ahn H, et al. Transabdominal evaluation of uterine cervical length during pregnancy fails to identify a substantial number of women with a short cervix [J]. J Matern Fetal Neonatal Med, 2012, 25(9): 1682-1689.
15
Gauthier T, Marin B, Garuchet-Bigot A, et al. Transperineal versus transvaginal ultrasound cervical length measurement and preterm labor [J]. Arch Gynecol Obstet, 2014, 290(3): 465-469.
16
Meijer-Hoogeveen M, Stoutenbeek P, Visser GH. Transperineal versus transvaginal sonographic cervical length measurement in second- and third-trimester pregnancies [J]. Ultrasound Obstet Gynecol, 2008, 32(5): 657-662.
17
Lim K, Butt K, Crane JM, et al. SOGC Clinical Practice Guideline. Ultrasonographic cervical length assessment in predicting preterm birth in singleton pregnancies [J]. J Obstet Gynaecol Can, 2011, 33(5): 486-499.
18
张欣荣. 经腹部与经阴道超声检查诊断孕妇宫颈机能不全的临床价值 [J]. 中国妇幼保健, 2017, 32(11): 2483-2485.
19
Newnham JP, White SW, Meharry S, et al. Reducing preterm birth by a statewide multifaceted program: an implementation study [J]. Am J Obstet Gynecol, 2017, 216(5): 434-442.
20
Ophir J, Céspedes I, Ponnekanti H, et al. Elastography: a quantitative method for imaging the elasticity of biological tissues [J]. Ultrason Imaging, 1991, 13(2): 111-134.
21
时春艳, 张云燕, 金燕志, 等. 阴道超声测量子宫颈长度及宫颈管宽度对预测早产的价值 [J]. 中华妇产科杂志, 2003, 38(5): 11-13.
22
Spiegelman J, Booker W, Gupta S, et al. The independent association of a short cervix, positive fetal fibronectin, amniotic fluid sludge, and cervical funneling with spontaneous preterm birth in twin pregnancies [J]. Am J Perinatol, 2016, 33(12): 1159-1164.
23
Andersen HF, Nugent CE, Wanty SD, et al. Prediction of risk for preterm delivery by ultrasonographic measurement of cervical length [J]. Am J Obstet Gynecol, 1990, 163(3): 859-867.
24
Cook JR, Chatfield S, Chandiramani M, et al. Cerclage position, cervical length and preterm delivery in women undergoing ultrasound indicated cervical cerclage: a retrospective cohort study [J]. PLoS One, 2017, 12(6): e0178072.
25
Kindinger LM, Bennett PR, Lee YS, et al. The interaction between vaginal microbiota, cervical length, and vaginal progesterone treatment for preterm birth risk [J]. Microbiome, 2017, 5(1): 6.
26
Celik E, To M, Gajewska K, et al. Cervical length and obstetric history predict spontaneous preterm birth: development and validation of a model to provide individualized risk assessment [J]. Ultrasound Obstet Gynecol, 2008, 31(5): 549-554.
27
Guzman ER, Walters C, O'reilly-Green C, et al. Use of cervical ultrasonography in prediction of spontaneous preterm birth in triplet gestations [J]. Am J Obstet Gynecol, 2000, 183(5): 1108-1113.
28
Rozenberg P. Universal cervical length screening for singleton pregnancies with no history of preterm delivery, or the inverse of the Pareto principle [J]. BJOG, 2017, 124(7): 1038-1045.
29
Kiely JL. What is the population-based risk of preterm birth among twins and other multiples? [J]. Clin Obstet Gynecol, 1998, 41(1): 3-11.
30
Klein K, Gregor H, Hirtenlehner-Ferber K, et al. Prediction of spontaneous preterm delivery in twin pregnancies by cervical length at mid-gestation [J]. Twin Res Hum Genet, 2008, 11(5): 552-557.
31
贺瑶谦, 解丽梅. 经阴道超声测量宫颈长度预测无症状双胎早产的诊断效能的 Meta 分析 [J]. 中国医科大学学报 , 2014, 43(11): 1023-1027, 1032.
32
Kindinger LM, Poon LC, Cacciatore S, et al. The effect of gestational age and cervical length measurements in the prediction of spontaneous preterm birth in twin pregnancies: an individual patient level meta- analysis [J]. BJOG, 2016, 123(6): 877-884.
33
Moroz LA, Brock CO, Govindappagari S, et al. Association between change in cervical length and spontaneous preterm birth in twin pregnancies [J]. Am J Obstet Gynecol, 2017, 216(2): 159.e1-159. e7.
34
Pagani G, Stagnati V, Fichera A, et al. Cervical length at mid-gestation in screening for preterm birth in twin pregnancy [J]. Ultrasound Obstet Gynecol, 2016, 48(1): 56-60.
35
夏晓艳, 黄醒华, 翟桂荣. 双胎及三胎妊娠的临床特点 [J]. 基础医学与临床, 2004, 24(5): 586-588.
36
Maslovitz S, Hartoov J, Wolman I, et al. Cervical length in the early second trimester for detection of triplet pregnancies at risk for preterm birth [J]. J Ultrasound Med, 2004, 23(9): 1187-1191.
37
Fichera A, Pagani G, Stagnati V, et al. Cervical-length measurement in mid-gestation to predict spontaneous preterm birth in asymptomatic triplet pregnancy [J]. Ultrasound Obstet Gynecol, 2018, 51(5): 614-620.
38
Greco E, Gupta R, Syngelaki A, et al. First-trimester screening for spontaneous preterm delivery with maternal characteristics and cervical length [J]. Fetal Diagn Ther, 2012, 31(3): 154-161.
39
Conoscenti G, Meir YJ, D′Ottavio G, et al. Does cervical length at 13-15 weeks′ gestation predict preterm delivery in an unselected population? [J]. Ultrasound Obstet Gynecol, 2003, 21(2): 128-134.
40
Greco E, Lange A, Ushakov F, et al. Prediction of spontaneous preterm delivery from endocervical length at 11 to 13 weeks [J]. Prenat Diagn, 2011, 31(1): 84-89.
41
Esplin MS, Elovitz MA, Iams JD, et al. Predictive accuracy of serial transvaginal cervical lengths and quantitative vaginal fetal fibronectin levels for spontaneous preterm birth among nulliparous women [J]. JAMA, 2017, 317(10): 1047-1056.
42
Hiersch L, Yogev Y, Domniz N, et al. The role of cervical length in women with threatened preterm labor: is it a valid predictor at any gestational age? [J]. Am J Obstet Gynecol, 2014, 211(5): 532.e1-9.
43
曲雪凌. 超声在自发性早产预测方面的研究 [M]. 济南: 山东大学, 2016: 44.
44
Wozniak S, Czuczwar P, Szkodziak P, et al. Elastography in predicting preterm delivery in asymptomatic, low-risk women: a prospective observational study [J]. BMC Pregnancy Childbirth, 2014, 14: 238.
45
Hernandez-Andrade E, Garcia M, Ahn H, et al. Strain at the internal cervical os assessed with quasi-static elastography is associated with the risk of spontaneous preterm delivery at ≤34 weeks of gestation [J]. J Perinat Med, 2015, 43(6): 657-666.
46
Du L, Zhang LH, Zheng Q, et al. Evaluation of Cervical elastography for prediction of spontaneous preterm birth in low-risk women: a prospective study [J]. J Ultrasound Med, 2020, 39(4): 705-713.
47
王明玥, 顾欣贤, 陈珊珊, 等. 宫颈剪切波 E 成像技术在预测孕妇早产中的临床运用 [J]. 现代妇产科进展, 2019, 28(5): 378-380.
48
韩欢, 包怡榕, 瞿晓娴, 等. 宫颈托预防早产的研究进展 [J]. 国际妇产科学杂志, 2015, 42(6): 693-697.
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