三维能量多普勒超声鉴别宫颈过短孕妇先兆早产的作用研究

目的：使用三维能量多普勒超声比较先兆早产和无症状宫颈过短单胎孕妇的宫颈体积和血管指数。方法：预先扫描妊娠 24-34.6 周的300 例无症状健康孕妇的宫颈长度。将宫颈长度过短，小于孕周的10%的孕妇纳入无症状宫颈短组，测量该组孕妇宫 颈体积和血管指数（Ⅵ）、血管血流指数（VFI）和血流指数（FI）。先兆早产组患者入院的24 小时内测量同样的超声参数。记录孕妇 的体重指数、孕周、吸烟状况、经产状况、早产家族史、母亲为早产出生者以及之前的早产情况等数据。比较两组孕妇超声检查结 果和病史参数。结果：29 例无症状健康妇女（9.6%）宫颈较短。两组间的病史参数或宫颈长度无显著差异。先兆早产组的宫颈体积 较小（12.90 vs 17.168 cm3，P = 0.005）。无症状宫颈过短孕妇的VI 和VFI 均较低（VI：4.369% vs 15.939%，P<0.001；VFI：1.514 vs 4.878，P<0.001）。宫颈过短组的FI较高（33.581 vs 30.311，P=0.006）。结论：无症状宫颈过短组孕妇与先兆早产组孕妇之间的宫颈 长度类似，但两组间宫颈体积和血管指数存在差异。

Effects of Three-dimensional Power Doppler Ultrasound to Identify Asymptomatic Pregnant Women with a Short Cervix Threatened Preterm Labor

Objective:To compare cervical volumes and vascularization indices of singleton pregnancies with threatened preterm labor or asymptomatic short cervix by using 3-dimensional power Doppler ultrasound.Methods:Three hundred asymptomatic healthy pregnant women between 24 and 34.6 gestational weeks were prospectively scanned for cervical length. The pregnant women with too short cervical length or less than 10 percent of gestational age were included in asymptomatic short cervix group, and their cervical volume and vascularization indices (vascularization index VI], vascularization-flow index VFI], and flow index FI]) were measured. During this period, the same sonographic parameters were measured among patients with threatened preterm labor during the first 24 hours after admission. Data on body mass index, maternal age, smoking, parity, family history of preterm birth, mother who was born preterm, and previous preterm birth among the pregnant women were recorded. Sono-graphic and medical history parameters were compared between the two groups.Results:Twenty-nine asymptomatic healthy women (9.6%) had a short cervix. Additionally, 71 pregnancies with threatened preterm labor were scanned. There were no statistically significant differences between the groups in medical history parameters or cervical length. The cervical volume was smaller in threatened preterm cases (12.90 cm3 versus 17.168 cm3; P = 0.005). The VI and VFI were lower in women with an asymptomatic short cervix (VI, 4.369%versus 15.939%; P < 0.001; VFI, 1.514 versus 4.878; P < 0.001). The FI was higher in the short cervix group (33.581 versus 30.311; P =0.006).Conclusion:There were differences in cervical volume and vascularization indices between pregnancies with an asymptomatic short cervix and cases with threatened preterm labor, although cervical length was similar in both groups.