摘要
目的观察宫颈E-Cervix参数联合宫颈长度(CL)预测足月分娩方式的价值。方法回顾性分析73名足月单胎头位孕妇临产前经阴道灰阶超声及E-Cervix资料,其中23名试产失败转剖宫产(剖宫产组)、50名成功经阴道分娩(阴道分娩组);比较组间CL、宫颈弹性对比指数(ECI)、硬度比值(HR)、内口应变值(IOS)、外口应变值(EOS)及IOS/EOS;以分娩结局为金标准,绘制受试者工作特征曲线,计算曲线下面积(AUC),观察基于CL、E-Cervix参数及其联合预测分娩方式的效能。结果剖宫产组CL及HR均高于、ECI及IOS均低于阴道分娩组(P均<0.05);组间EOS、IOS/EOS差异均无统计学意义(P均>0.05)。以单一CL、ECI、HR及IOS预测分娩方式的AUC分别为0.748、0.747、0.694及0.733;CL联合ECI及联合上述4个变量预测分娩方式的AUC分别为0.797及0.818,其间差异无统计学意义(P>0.05)。结论宫颈E-Cervix参数ECI、HR及IOS联合CL能有效预测足月分娩方式;ECI联合CL更适于初步预测。
Objective To observe the value of cervical E-Cervix parameters combined with cervical length(CL)for predicting the term delivery mode.Methods Transvaginal gray-scale ultrasound and E-Cervix data obtained before labor of 73 pregnant women with term singleton cephalic presentation were retrospectively analyzed.Among 73 pregnant women,23 failed in trial of labor and converted to cesarean section(cesarean section group),while 50 achieved successful vaginal delivery(vaginal delivery group).CL,cervical elasticity contrast index(ECI),hardness ratio(HR),internal os strain(IOS),external os strain(EOS)and IOS/EOS were compared between groups.Taken delivery outcome as gold standard,receiver operating characteristic curves were plotted,and the area under the curves(AUC)was calculated to evaluate the efficacy of CL and E-Cervix parameters alone and their combination for predicting the mode of delivery.Results CL and HR were both significantly higher,while ECI and IOS were significantly lower in cesarean section group than those in vaginal delivery group(all P<0.05).No significant difference of EOS nor IOS/EOS was found between groups(both P>0.05).AUC of CL,ECI,HR and IOS alone for predicting the delivery mode was 0.748,0.747,0.694 and 0.733,respectively.The AUC of CL combined with ECI and the combination of all above 4 variables for predicting delivery mode was 0.797 and 0.818,respectively,not being significantly different(P>0.05).Conclusion Cervical E-Cervix parameters(ECI,HR,IOS)combined with CL could be used to effectively predict the delivery mode in term pregnancy.The combination of ECI and CL was simpler and suitable for preliminary prediction.
作者
刘丽萍
路小军
包艳娟
王玉波
何莎
高艳多
崔一珍
杨彬
谢峰
LIU Liping;LU Xiaojun;BAO Yanjuan;WANG Yubo;HE Sha;GAO Yanduo;CUI Yizhen;YANG Bin;XIE Feng(Department of Ultrasound,Maternal and Child Health Hospital of Hubei Province,Wuhan 430070,China)
出处
《中国医学影像技术》
北大核心
2026年第2期239-243,共5页
Chinese Journal of Medical Imaging Technology
基金
湖北省妇幼保健院院内科研项目(2021SFYM029)。
关键词
足月分娩
剖宫产术
超声检查
term birth
cesarean section
ultrasonography
