Prediction and early detection of preterm labor
Prediction and early detection of preterm labor
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DOI：
10.1016/s0029-7844(02)02505-x
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发表时间：
2003-02-01
影响因子：
7.2
通讯作者：
Iams, JD
中科院分区：
文献类型：
--
作者：
Iams, JD
孕期对宫颈超声、胎儿纤维连接蛋白以及子宫收缩监测的研究提高了我们对早产发生机制的理解，但它们在实际应用中的作用仍不明确。本文综述了这些检测方法在提高早产诊断准确性以及评估有既往危险因素的女性早产可能性方面的应用。由于在分娩明确确立之前，早产的临床诊断标准并不准确，过度诊断很常见。对于可能早产的患者，如果宫颈长度测量大于30毫米或胎儿纤维连接蛋白检测呈阴性，则可避免过度诊断和不必要的治疗。宫颈超声或胎儿纤维连接蛋白的常规使用在筛查孕妇早产风险方面没有作用，但检测结果为阴性可能会使被认为风险增加的女性放心。子宫收缩监测在检测有早产风险的女性方面敏感性较低。目前，孕期宫颈长度和胎儿纤维连接蛋白的应用仅限于阴性结果可避免不必要干预的情况。（C）2003年美国妇产科医师学会版权所有
Studies of cervical sonography, fetal fibronectin, and uterine contraction monitoring during pregnancy have improved our understanding of how preterm labor occurs, but their use in practice remains uncertain. This article reviews the use of these tests to improve the accuracy of diagnosis of preterm labor and to estimate the likelihood of preterm birth in women with historical risk factors. Because the clinical criteria for a diagnosis of preterm labor are inaccurate until labor is well established, over-diagnosis is common. A cervical length measurement of more than 30 mm or a negative fibronectin obtained from a patient with possible preterm labor can avoid over-diagnosis and unnecessary treatment. There is no role for routine use of either cervical sonography or fibronectin to screen pregnant women for preterm birth risk, but women thought to be at increased risk may be reassured by negative test results. Uterine contraction monitoring has low sensitivity for detecting women at risk of preterm birth. Current use of cervical length and fetal fibronectin in pregnancy is limited to situations where a negative result can avoid unnecessary interventions. (C) 2003 by The American College of Obstetricians and Gynecologists.