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首页> 外文期刊>International Journal of Reproduction, Contraception, Obstetrics and Gynecology >To study the efficacy of digital and transvaginal ultrasonographic measurement of cervical length in asymptomatic high risk women at POG 16-24 weeks as a predictor of preterm delivery and progesterone and cerclage vs. progesterone alone for short cervical length in prevention of preterm labour
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To study the efficacy of digital and transvaginal ultrasonographic measurement of cervical length in asymptomatic high risk women at POG 16-24 weeks as a predictor of preterm delivery and progesterone and cerclage vs. progesterone alone for short cervical length in prevention of preterm labour

机译：研究数字和经阴道超声检查在无症状高危女性于POG 16-24周时宫颈长度的预测早产和孕酮和环扎物与单独使用孕激素相比短宫颈长度对预防早产的疗效

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Background: Objectives of current study were (i) To correlate the Cervical Length (CL) measured digitally and by transvaginal sonography (TVS) at 16 to 24 weeks with outcome of pregnancy (ii) Estimate risk of spontaneous preterm labour (PTL) based on CL measurements and (iii) study intervention in short CL and their effect on maternal and neonatal outcome. Methods: Women with singleton pregnancy at POG 16-24 weeks with history of previous preterm birth or mid trimester abortions were included in the study and subjected to digital assessment of CL followed by TVS measurement. In patients with TVS CL ≤25 mm, intervention in the form of progesterone or cerclage with progesterone was done. The outcome of the pregnancy in the form of delivery before completed 37 weeks or at and after 37 weeks was noted. Results: Twenty two subjects out of total 153 subjects (14.4%) had preterm delivery. The incidence of preterm delivery in study was 14.4%. Using Receiver Operating Characteristics (ROC) Curve, cut off value of digital CL was found to be 1.5 cm. The sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy of digital CL ≤1.5 cm in prediction of PTL were 72.7 %, 37.4%, 16.3%, 89.1% and 42.5% respectively. Cut off value of TVS CL by ROC curve was found to be 2.85 cm. The sensitivity, specificity, PPV, NPV and accuracy of CL (TVS) of ≤2.85 cm in prediction of PTL is 81.8%, 68.7%, 30.5%, 95.7%, 70.6% respectively. The outcome in form of PTL in 30 subjects, who had TVS CL ≤2.5 cm in both the intervention groups (McDonald stitch with progesterone and progesterone alone) was comparable (P value 0.60 not significant). Conclusions: The CL, both digitally and by TVS, was inversely correlated with the probability of preterm delivery so that the shorter the cervix, the greater the likelihood of preterm delivery. TVS CL is more predictive of preterm delivery than digital CL when performed between 16-24 weeks in asymptomatic high risk women. Intervention in short CL in form of McDonald's stitch application with progesterone and progesterone alone have similar efficacy for prevention of PTL.
机译：背景：本研究的目的是（i）将数字化和经阴道超声检查（TVS）在16至24周时测得的宫颈长度（CL）与妊娠结局相关（ii）根据以下数据估算自发性早产风险CL测量和（iii）研究短期CL的干预措施及其对母体和新生儿结局的影响。方法：本研究包括在POG 16-24周单胎妊娠且有早产史或早中期流产史的妇女，并对她们进行CL的数字评估，然后进行TVS测量。在TVS CL≤25 mm的患者中，进行了孕酮干预或孕酮环扎术。记录了在完成37周之前或在37周和之后分娩形式的妊娠结局。结果：153名受试者中的22名受试者（14.4％）早产。研究中早产的发生率为14.4％。使用接收器工作特性（ROC）曲线，发现数字CL的截止值为1.5 cm。数字CL≤1.5cm预测PTL的敏感性，特异性，阳性预测值（PPV），阴性预测值（NPV）和准确性分别为72.7％，37.4％，16.3％，89.1％和42.5％。通过ROC曲线得到的TVS CL的截止值为2.85cm。预测PTL≤2.85cm的敏感性，特异性，PPV，NPV和CL（TVS）的准确度分别为81.8％，68.7％，30.5％，95.7％，70.6％。在两个干预组中，TVS CL≤2.5cm的30名受试者（单独使用孕激素的麦当劳缝线和单独使用孕激素）的PTL形式的结果均具有可比性（P值0.60不显着）。结论：数字和TVS的CL与早产的可能性成反比，因此子宫颈越短，早产的可能性就越大。在无症状的高危女性中，TVS CL在16-24周之间执行时比数字CL更能预测早产。以麦当劳缝线形式对短CL进行干预，单独使用孕激素和单独使用孕激素在预防PTL方面具有相似的功效。

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