A soft cervix, categorized by shear-wave elastography, in women with short or with normal cervical length at 18-24 weeks is associated with a higher prevalence of spontaneous preterm delivery.
A soft cervix, categorized by shear-wave elastography, in women with short or with normal cervical length at 18-24 weeks is associated with a higher prevalence of spontaneous preterm delivery.
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DOI：
10.1515/jpm-2018-0062
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发表时间：
2018-07-26
影响因子：
2.4
通讯作者：
Romero R
中科院分区：
文献类型：
--
作者：
Hernandez-Andrade E;Maymon E;Luewan S;Bhatti G;Mehrmohammadi M;Erez O;Pacora P;Done B;Hassan SS;Romero R
确定在妊娠18-24周之间通过剪切波弹性成像确定的软宫颈是否与自发性早产（sPTD）频率增加相关。这项前瞻性队列研究包括628名连续的单胎妊娠妇女。在妊娠18-24周时测量宫颈长度（mm）和宫颈内口的柔软度[剪切波速度：（SWS）米/秒（m/s）]。在有和没有短宫颈（≤ 25 mm）和/或软宫颈（SWS <25百分位数）的妇女中，比较妊娠sPTD <37（sPTD <37）和<34（sPTD <34）周的频率。有31/628（4.9%）sPTD < 37和12/628（1.9%）sPTD < 34分娩。宫颈较软且较短者sPTD < 37的风险增加18倍[相对风险（RR）18.0（95%置信区间[CI]，7.7-43.9）; P < 0.0001]和sPTD < 34的风险120倍[RR 120.0（95% CI 12.3-1009.9）; P < 0.0001]与宫颈长度正常的女性相比。与非软宫颈相比，仅软宫颈使sPTD < 37的风险增加4.5倍[RR 4.5（95%CI 2.1-9.8）; P = 0.0002]，使sPTD < 34的风险增加21倍[RR 21.0（95%CI 2.6-169.3）; P = 0.0003]。妊娠18-24周的软宫颈增加了妊娠<37和<34周的sPTD的风险，与宫颈长度无关。
To determine whether a soft cervix identified by shear-wave elastography between 18-24 weeks of gestation is associated with increased frequency of spontaneous preterm delivery (sPTD). This prospective cohort study included 628 consecutive women with a singleton pregnancy. Cervical length (mm) and softness [shear-wave speed: (SWS) meters per second (m/s)] of the internal cervical os were measured at 18-24 weeks of gestation. Frequency of sPTD <37 (sPTD <37) and <34 (sPTD <34) weeks of gestation was compared among women with and without a short (≤ 25mm) and/or a soft cervix (SWS <25th percentile). There were 31/628 (4.9%) sPTD < 37 and 12/628 (1.9%) sPTD < 34 deliveries. The combination of a soft and a short cervix increased the risk of sPTD < 37 by 18-fold [relative risk (RR) 18.0 (95% confidence interval [CI], 7.7–43.9); P < 0.0001] and the risk of sPTD < 34 by 120-fold [RR 120.0 (95% CI 12.3–1009.9); P < 0.0001] compared to women with normal cervical length. A soft-only cervix increased the risk of sPTD < 37 by 4.5-fold [RR 4.5 (95% CI 2.1–9.8); P = 0.0002] and of sPTD < 34 by 21-fold [RR 21.0 (95% CI 2.6–169.3); P = 0.0003] compared to a non-soft cervix. A soft cervix at 18–24 weeks of gestation increases the risk of sPTD <37 and <34 weeks of gestation independently of cervical length.