<strong>Objectives:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">Although an asymptomatic short cervix is a risk fact...<strong>Objectives:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">Although an asymptomatic short cervix is a risk factor for spontaneous preterm birth (SPTB), the risk factors for SPTB among those with short cervix remain unknown. We herein investigated risk factors for preterm delivery (PTD) at <34 weeks of gestation in pregnant women with a short cervix. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study. Seventy-three asymptomatic pregnant women with a sonographic short cervix (excluding visible bulging fetal membranes) were selected, and the relationship between clinical or biochemical risk factors and preterm delivery (PTD) at <34 weeks was examined.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Thirteen cases (17.8%) had PTD at <34 weeks. A univariate analysis showed that a history of SPTD, gestational weeks on admission, cervical length, cervical mucus interleukin (CM-IL)-8 and amniotic fluid interleukin (AF-IL)-8 in PTD at <34 weeks significantly differed from those in delivery at </span><span style="font-family:Verdana;">≥34 weeks (p < 0.05, respectively). A multiple logistic regression analysis i</span><span style="font-family:Verdana;">dentified CM-IL-8 ≥ 803.5 ng/mL [21.3 (3.0 - 260), </span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.002] and cervical length ≤15 mm [17.1 (1.9 - 517), </span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.008] as independent risk factors for PTD at <34 weeks.</span><b><span style="font-family:Verdana;"> Conclusions:</span></b><span style="font-family:Verdana;"> Evaluation for cervical inflammation may be necessary for appropriate treatment strategies in asymptomatic pregnant women with a short cervix. Cervical inflammation warrants further study.</span></span></span></span>展开更多
近年来早产发生率呈上升趋势,而大多数在妊娠34周前分娩的孕妇既往没有早产史。由于子宫颈缩短与早产的发生相关,因此评估宫颈长度并针对性地采取预防措施可减少早产的发生。经阴道超声评估妊娠中期宫颈长度是临床上预测自发性早产的最...近年来早产发生率呈上升趋势,而大多数在妊娠34周前分娩的孕妇既往没有早产史。由于子宫颈缩短与早产的发生相关,因此评估宫颈长度并针对性地采取预防措施可减少早产的发生。经阴道超声评估妊娠中期宫颈长度是临床上预测自发性早产的最佳方法之一。2024年美国母胎医学会(Society for Maternal-Fetal Medicine,SMFM)发布了咨询系列第70号文件《无自然早产史女性短子宫颈的管理指南》,内容涵盖了宫颈长度的测量、短宫颈的定义及预防治疗措施,为没有早产史的短宫颈孕妇的诊断和治疗提供了指导。展开更多
目的探讨宫颈环扎术联合黄体酮阴道缓释凝胶预防短子宫颈双胎孕妇早产的效果。方法回顾性选取2022年6月至2024年8月济宁市第三人民医院收治的子宫颈长度≤1.5 cm且为双胎的孕妇60例,按照预防方案的不同分为联合组(n=30)和环扎组(n=30),...目的探讨宫颈环扎术联合黄体酮阴道缓释凝胶预防短子宫颈双胎孕妇早产的效果。方法回顾性选取2022年6月至2024年8月济宁市第三人民医院收治的子宫颈长度≤1.5 cm且为双胎的孕妇60例,按照预防方案的不同分为联合组(n=30)和环扎组(n=30),环扎组实施宫颈环扎术,联合组在环扎组的基础上给予黄体酮阴道缓释凝胶,比较两组妊娠结局、妊娠延长时间、分娩方式、新生儿情况和并发症总发生率。结果两组晚期流产率、并发症总发生率和胎儿存活率比较无差异(P>0.05);联合组分娩孕龄≥37周的占比、顺产率、新生儿出生1 min Apgar评分和出生体重均高于环扎组,妊娠延长时间长于环扎组,转新生儿科率低于环扎组(P<0.05)。结论宫颈环扎术联合黄体酮阴道缓释凝胶在短子宫颈双胎孕妇中的应用效果较好,可延长妊娠时间,提高顺产率,改善新生儿结局。展开更多
Objectives:The objective of our study is to examine cervical length measurements,identification of short cervix,vaginal progesterone use,and rate of spontaneous preterm delivery before and after departmental transitio...Objectives:The objective of our study is to examine cervical length measurements,identification of short cervix,vaginal progesterone use,and rate of spontaneous preterm delivery before and after departmental transition to a universal transvaginal ultrasound screening protocol from a universal transabdominal screening protocol.Methods:This is a retrospective observational pre-post study examining the year prior to and year following a transition to a universal transvaginal ultrasound screening protocol to assess cervical length at the time of the anatomy survey.Prior to this transition,universal transabdominal cervical length screening was performed,with reflex transvaginal ultrasound measurement if transabdominal measurement was<35 mm or was unable to be obtained.Results:A total of 1760 charts were reviewed;962 charts were from the pre-transition/transabdominal year and 798 charts were from the post-transition/transvaginal year.In the post-transition/transvaginal year,cervical length less than 20 mm was identified in 1.5%of cases,compared to 0.7%of cases in the pretransition/transabdominal year(p=0.114).There was no difference in the rate of spontaneous preterm delivery between the two groups(5.1%in the pre-transition/transabdominal year vs.6.9%in the post-transition/transvaginal year;p=0.111).Conclusions:In this pre-post study,introduction of a universal transvaginal cervical length screening did not decrease spontaneous preterm delivery rates or detection of short cervix<20 mm,compared to a protocol of universal transabdominal cervical length screening with reflex to transvaginal for measurement<35 mm.展开更多
目的探讨阴道宫颈环扎术联合黄体酮阴道缓释凝胶对单胎妊娠短子宫颈孕妇妊娠结局的影响。方法将南阳市卧龙区妇幼保健院自2019年12月至2020年12月收治的100例单胎妊娠短子宫颈孕妇,以随机数字表达法分为研究组(50例,阴道宫颈环扎术+阴...目的探讨阴道宫颈环扎术联合黄体酮阴道缓释凝胶对单胎妊娠短子宫颈孕妇妊娠结局的影响。方法将南阳市卧龙区妇幼保健院自2019年12月至2020年12月收治的100例单胎妊娠短子宫颈孕妇,以随机数字表达法分为研究组(50例,阴道宫颈环扎术+阴道注射黄体酮缓释凝胶治疗)与对照组(50例,阴道宫颈环扎术治疗),对比两组患者治疗前后的子宫内膜容受性评分、保胎时间、晚期流产率、早产率、分娩孕龄≥38周、新生儿出生时体重、1 min Agpar评分、死亡率、宫内窘迫发生率及产妇产后出血、宫颈裂伤、产褥期感染等并发症发生率。结果治疗前,两组患者子宫内膜容受性评分对比,差异无统计学意义(P>0.05),治疗后,研究组患者子宫内膜容受性评分显著高于对照组,研究组患者保胎时间显著短于对照组,两组对比,差异有统计学意义(P<0.05);研究组晚期流产率、早产发生率、新生儿死亡率、宫内窘迫发生率及产妇产后并发症发生率均显著低于对照组,孕妇分娩孕周孕龄≥38周率明显大于对照组,两组对比,差异有统计学意义(P<0.05);研究组分娩孕龄、新生儿体重及新生儿Agpar评分显著高于对照组,两组对比,差异有统计学意义(P<0.05)。结论阴道宫颈环扎术联合黄体酮阴道缓释凝胶有助于降低单胎妊娠短子宫颈流产、早产率,有助于母婴结局的改善及并发症的预防。展开更多
文摘<strong>Objectives:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">Although an asymptomatic short cervix is a risk factor for spontaneous preterm birth (SPTB), the risk factors for SPTB among those with short cervix remain unknown. We herein investigated risk factors for preterm delivery (PTD) at <34 weeks of gestation in pregnant women with a short cervix. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study. Seventy-three asymptomatic pregnant women with a sonographic short cervix (excluding visible bulging fetal membranes) were selected, and the relationship between clinical or biochemical risk factors and preterm delivery (PTD) at <34 weeks was examined.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Thirteen cases (17.8%) had PTD at <34 weeks. A univariate analysis showed that a history of SPTD, gestational weeks on admission, cervical length, cervical mucus interleukin (CM-IL)-8 and amniotic fluid interleukin (AF-IL)-8 in PTD at <34 weeks significantly differed from those in delivery at </span><span style="font-family:Verdana;">≥34 weeks (p < 0.05, respectively). A multiple logistic regression analysis i</span><span style="font-family:Verdana;">dentified CM-IL-8 ≥ 803.5 ng/mL [21.3 (3.0 - 260), </span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.002] and cervical length ≤15 mm [17.1 (1.9 - 517), </span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.008] as independent risk factors for PTD at <34 weeks.</span><b><span style="font-family:Verdana;"> Conclusions:</span></b><span style="font-family:Verdana;"> Evaluation for cervical inflammation may be necessary for appropriate treatment strategies in asymptomatic pregnant women with a short cervix. Cervical inflammation warrants further study.</span></span></span></span>
文摘近年来早产发生率呈上升趋势,而大多数在妊娠34周前分娩的孕妇既往没有早产史。由于子宫颈缩短与早产的发生相关,因此评估宫颈长度并针对性地采取预防措施可减少早产的发生。经阴道超声评估妊娠中期宫颈长度是临床上预测自发性早产的最佳方法之一。2024年美国母胎医学会(Society for Maternal-Fetal Medicine,SMFM)发布了咨询系列第70号文件《无自然早产史女性短子宫颈的管理指南》,内容涵盖了宫颈长度的测量、短宫颈的定义及预防治疗措施,为没有早产史的短宫颈孕妇的诊断和治疗提供了指导。
文摘目的探讨宫颈环扎术联合黄体酮阴道缓释凝胶预防短子宫颈双胎孕妇早产的效果。方法回顾性选取2022年6月至2024年8月济宁市第三人民医院收治的子宫颈长度≤1.5 cm且为双胎的孕妇60例,按照预防方案的不同分为联合组(n=30)和环扎组(n=30),环扎组实施宫颈环扎术,联合组在环扎组的基础上给予黄体酮阴道缓释凝胶,比较两组妊娠结局、妊娠延长时间、分娩方式、新生儿情况和并发症总发生率。结果两组晚期流产率、并发症总发生率和胎儿存活率比较无差异(P>0.05);联合组分娩孕龄≥37周的占比、顺产率、新生儿出生1 min Apgar评分和出生体重均高于环扎组,妊娠延长时间长于环扎组,转新生儿科率低于环扎组(P<0.05)。结论宫颈环扎术联合黄体酮阴道缓释凝胶在短子宫颈双胎孕妇中的应用效果较好,可延长妊娠时间,提高顺产率,改善新生儿结局。
文摘Objectives:The objective of our study is to examine cervical length measurements,identification of short cervix,vaginal progesterone use,and rate of spontaneous preterm delivery before and after departmental transition to a universal transvaginal ultrasound screening protocol from a universal transabdominal screening protocol.Methods:This is a retrospective observational pre-post study examining the year prior to and year following a transition to a universal transvaginal ultrasound screening protocol to assess cervical length at the time of the anatomy survey.Prior to this transition,universal transabdominal cervical length screening was performed,with reflex transvaginal ultrasound measurement if transabdominal measurement was<35 mm or was unable to be obtained.Results:A total of 1760 charts were reviewed;962 charts were from the pre-transition/transabdominal year and 798 charts were from the post-transition/transvaginal year.In the post-transition/transvaginal year,cervical length less than 20 mm was identified in 1.5%of cases,compared to 0.7%of cases in the pretransition/transabdominal year(p=0.114).There was no difference in the rate of spontaneous preterm delivery between the two groups(5.1%in the pre-transition/transabdominal year vs.6.9%in the post-transition/transvaginal year;p=0.111).Conclusions:In this pre-post study,introduction of a universal transvaginal cervical length screening did not decrease spontaneous preterm delivery rates or detection of short cervix<20 mm,compared to a protocol of universal transabdominal cervical length screening with reflex to transvaginal for measurement<35 mm.
文摘目的探讨阴道宫颈环扎术联合黄体酮阴道缓释凝胶对单胎妊娠短子宫颈孕妇妊娠结局的影响。方法将南阳市卧龙区妇幼保健院自2019年12月至2020年12月收治的100例单胎妊娠短子宫颈孕妇,以随机数字表达法分为研究组(50例,阴道宫颈环扎术+阴道注射黄体酮缓释凝胶治疗)与对照组(50例,阴道宫颈环扎术治疗),对比两组患者治疗前后的子宫内膜容受性评分、保胎时间、晚期流产率、早产率、分娩孕龄≥38周、新生儿出生时体重、1 min Agpar评分、死亡率、宫内窘迫发生率及产妇产后出血、宫颈裂伤、产褥期感染等并发症发生率。结果治疗前,两组患者子宫内膜容受性评分对比,差异无统计学意义(P>0.05),治疗后,研究组患者子宫内膜容受性评分显著高于对照组,研究组患者保胎时间显著短于对照组,两组对比,差异有统计学意义(P<0.05);研究组晚期流产率、早产发生率、新生儿死亡率、宫内窘迫发生率及产妇产后并发症发生率均显著低于对照组,孕妇分娩孕周孕龄≥38周率明显大于对照组,两组对比,差异有统计学意义(P<0.05);研究组分娩孕龄、新生儿体重及新生儿Agpar评分显著高于对照组,两组对比,差异有统计学意义(P<0.05)。结论阴道宫颈环扎术联合黄体酮阴道缓释凝胶有助于降低单胎妊娠短子宫颈流产、早产率,有助于母婴结局的改善及并发症的预防。
