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宫角在预测自发早产:一个系统的审查和元分析

Michael Jeffrey Goldstein¹, Jessica Marie Bailer², Veronica Mayela Gonzalez-Brown³

¹Department of Gynecologic Surgery and Obstetrics, Naval Medical Center Portsmouth, Portsmouth, VA (Dr Goldstein).

AJOG global reports

|July 3, 2023

概括

宫角在自发早产时较大,但对于预测而言,仅仅是宫长度并不优于宫长度. 结合两种测量方法并没有提高预测准确度,仅仅是宫长度.

科学领域:

生殖医学生殖医学
孕产妇和胎儿医学孕产妇和胎儿医学
产科产科产科产科产科

背景情况:

自发早产 (sPTB) 是新生儿发病率和死亡率的主要原因.
准确预测sPTB对于及时干预和改善结果至关重要.
子宫角 (UCA) 和子宫长度 (CL) 是用于评估子宫状态的超声波标记.

研究的目的:

为了比较术期和自发早产分娩队伍之间的子宫角.
评估UCA和CL在预测sPTB方面的诊断性能.
评估UCA和CL的结合是否与单独的每项措施相比改善了预测.

主要方法:

从1945年到2022年出版的文学作品的系统审查和元分析.
包括15项包括6218名患者的队列研究.
随机效应模型用于计算平均差异和赔率比率.

主要成果:

在自发早产队列中,UCA显著更大 (平均差异13.76,P<.00001).
单独对UCA的聚合灵敏度为0.70,单独对CL的聚合灵敏度为0.46.
单单UCA的聚合特异性为0.67,单单CL的聚合特异性为0.90. AUC为UCA的0.77和CL的0.82 .

结论:

虽然UCA在sPTB中较大,但它在预测sPTB方面并不优于单独的CL.
将UCA与CL结合起来并没有比单独CL提高预测性能.
目前的证据表明,单单CL仍然是sPTB的主要超声波预测因子.

关键词:

负面的怀孕结果.宫的长度宫的长度自发早产的超声波预测因素这是自发的早产.超声波超声波是指超声波的使用.宫角是子宫角的意思

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