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宫长度的预测值自发早产在宫围的妇女
K E Mountain1,2, S Ng1, T Elger3
1March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
概括
产后宫长度是34周前自发早产的主要预测因素. 虽然切尔克拉前的长度和变化很重要,但切尔克拉后的长度对于预测宫切尔克拉的女性的结果至关重要.
科学领域:
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 生殖医学 生殖医学
- 超声波在妇产科中的作用
背景情况:
- 宫围是预防自发早产 (sPTB) 的关键干预措施.
- 然而,治疗失败的成功率各不相同,因此需要对治疗失败的预测因素有更深入的了解.
- 识别这些因素可以优化患者的选择和改善妊娠结果.
研究的目的:
- 评估34周怀孕前自发早产 (sPTB) 产前和后宫长度 (CL) 的预测值.
- 评估基线风险因素对研究结果的影响.
主要方法:
- 在英国早产预防诊所 (2008-2021) 中,对331名接受子宫围的妇女进行了回顾性队列研究.
- 通过阴道的超声波被用来测量前和后的Circlage CL.
- 多变量逻辑回归和ROC曲线分析了CL对sPTB<34周的预测值;费舍尔的精确测试评估了风险因素差异.
主要成果:
- 在Cerclage前和之后的CL独立预测spTB<34周 (AUC分别为0.635和0.677).
- 循环后的CL是一个比循环前的CL (OR 0.964,P = 0.018) 更强的预测因素 (OR 0.940,P < 0.001).
- 根据种族,吸烟,先前的宫手术或怀孕史,没有观察到sPTB发病率的显著差异.
结论:
- 宫后的宫长度是34周怀孕前自发早产的占主导的超声波预测因素.
- 虽然基线风险因素可能会影响循环前的CL及其变化,但它们不能独立预测调整后的sPTB风险.
- 这些发现强调了宫后宫长度测量对宫患者风险评估的重要性.
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