Objective To investigate the clinical value of ultrasound elastography in predicting the time of labor in the cervix of full-term pregnancy.Methods A total of 85 full-term pregnant women who met the inclusion criteria and were hospitalized in the obstetrics ward of the Second Affiliated Hospital of Dalian Medical University between November 2021 and December 2022 were retrospectively selected.Statistical anal-ysis was conducted after delivery,with time to onset of labor(TOL)defined as the time difference between cervical parameters evaluated by trans-vaginal ultrasound(cervical length,strain rate,and ratio of internal and external cervical openings under the same area)and labor onset.The 85 pregnant women were divided into TOL＜7 d group(n=27)and TOL ≥7 d group(n=58).Basic data on pregnant women in 85 full-term pregnant women were recorded,including cervical length,strain rate,ratio of inner/outer cervix under same area;influencing factors on TOL were analyzed accordingly.Cervical length,position,elastic strain rate at inner/outer cervical orifices under same area as well as their ratios between two groups(TOL＜7 d vs.TOL≥7 d)were compared;influencing factors on these parameters also examined through logistic regression.Results After full-term pregnancy,the basic characteristics of the TOL quartile group of the pregnant women under examination were compared.Regard-less of whether it was the TOL≥7 d group or the TOL＜7 d group,there were statistically significant differences in gestational age(P=0.001)and cervical length(P=0.023)for predicting labor duration;the elastic strain rate of both the inner and outer cervical openings,as well as their ratio,did not show any statistical difference in predicting labor duration(P＞0.05).The cervical length of the TOL＜7 d group was(24.10± 5.48)mm,which was significantly smaller than that of the TOL ≥7 d group[(28.30±4.80)mm],the elastic strain rate of the cervical open-ing was 0.22±0.06,which was significantly higher than that of the TOL ≥7 d group(0.19±0.04),and the differences were statistically signif-icant(P＜0.05).However,there was no statistically significant difference between the TOL＜7 d group and the TOL≥7 d group in terms of age,gestational age,height,body mass index,cervical external opening elastic strain rate,and the ratio of elastic strain rate between the external and internal opening of the cervix(P＞0.05).Logistic regression analysis results for TOL≥7 d revealed that smaller gestational age,greater e-lasticity of external cervical opening,higher elasticity ratio between external and internal cervical openings,along with more than 10 days of time to onset of labor were independent risk factors(P＜0.05).Conclusion The independent factors of TOL were gestational age and cervical length.When TOL≥7 d,the greater the ratio of the change rate between the external and internal orifice,the smaller the elasticity rate of the in-ternal orifice,that is,the harder the internal orifice and the greater the elastic change rate of the external orifice,the more likely the delay occurs.Those with TOL less than 7 days have a shorter cervical length and a softer cervical opening.Therefore,cervical elastic imaging combined with pregnant women's gestational age and cervical length can predict the time of labor more accurately.
关键词
妊娠/子宫颈/预测/超声弹性成像/应变率/临产时间
Key words
Pregnancy/Cervix uteris/Prediction/Ultrasound elastic imaging/Strain rate/Time to onset of labor
维普
万方数据