spontaneous preterm birth (自発的早産) のリスクが高い女性の妊娠中期の内陰性超音波検査
1Department of Obstetrics and Gynecology, University of Alabama at Birmingham, 619 19th St S, OHB 458, Birmingham, AL 35249-7333, USA. johnowen@uab.edu
JAMA
|September 19, 2001
まとめ
妊娠16週から18週間の間に超音波で検出された子宮頸部の長さの短縮は,高リスクの女性の早産を予測します. 23週までの連続測定は,自発的な早産の予測精度を向上させます.
科学分野:
- 産婦人科と産婦人科を担当しています.
- 妊産婦・胎児医学について
- 診断用超音波検査について
背景:
- 子宮頸部の長さの短縮は,自発的な早産の危険因子として知られています.
- このリスクが明らかになる妊娠のタイミングはよく確立されていません.
研究 の 目的:
- 妊娠16週から18週,妊娠6日間の子宮頸部による超音波検査が,自発的早産を予測するかどうかを判断する.
- 23週6日までの連続子宮頸部評価が,高リスクの女性の予測を改善するかどうかを評価する.
主な方法:
- シングルトン妊娠の高リスクの183人の女性を対象とした盲検観察研究.
- 2週間の間隔で内陰性超音波検査を行い,子宮頸部の長さを測定し,フンネリングとダイナミック・ショートニングを記録した.
- 妊娠35週前の自発的な早産は,子宮頸部の長さのカットオフで分析された主な結果でした.
主要な成果:
- 最初のスキャンの時点で子宮頸部の長さが<25mm (16~18週,6日) であった場合,自発的早産のリスクが3.3倍に増加しました.
- 連続した子宮頸部の長さの測定,特に観察された最短の長さは,単一の測定と比較して予測を大幅に改善しました.
- 連続評価で観察された最短の子宮頸部長さを用いた場合,自発的早産の相対リスクは4.5に増加した.
結論:
- 妊娠16週から18週,6日間の子宮頸部の長さの内陰性超音波測定は,自発的な早産を予測します.
- 23週6日までの連続評価で最初の子宮頸部長さの測定を増加させると,高リスク集団における予測の正確性が向上します.
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