Predictive value of cervical anterior angle(ACA),cervical length(CL)and shear wave velocity(SWV)in risk of spontaneous preterm delivery with cervical incompetence
Objective To analyze the combined predictive value of anterior cervical angle(ACA),cervical length(CL),and shear wave velocity(SWV)in the risk of spontaneous preterm delivery with cervical dys-functions.Methods A total of 376 pregnant women with cervical incompetence were enrolled in the De-partment of Obstetrics and Gynecology of the hospitalfrom February to June 2023.The correlation be-tween ACA,CL,SWV and gestational weeks(19-23 w+6 d,24-27 w+6 d,28-33 w+6 d,34-36 w+6 d)was analyzed.All pregnant women were followed up to the completion of delivery and divided into preterm and non-preterm groups according to whether they were preterm or not.The general data of the 2 groups were compared,and the risk factors of preterm delivery in pregnant women with cervical immaturi-ty were analyzed by Logistic regression,and the prediction model was built according to the risk factors.Receiver Operating Characteristic curve(ROC)curve was used to analyze the single and combined predic-tive efficacy of ACA,CL and SWV on the risk of spontaneous preterm delivery in pregnant women with cervical imfunction.Pearson correlation was used to analyze the correlation between ACA,CLand SWV and gestational age of pregnant women with cervical dysfunction.Results There were significant differ-ences in SWV and CL among the pregnant women with cervical incompetence at different gestational weeks(P＜0.05),and SWV and CL showed a decreasing trend with the increase of gestational weeks(P＜0.05).There was no significant difference in ACA among the pregnant women with cervical dysfunction at different gestational weeks(P＞0.05).The results of Pearson correlation analysis showed that SWV and CL were negatively correlated with gestational age of pregnant women with cervical incompetence(r=-0.628,-0.867,P＜0.05),while ACA was not correlated with gestational age of the pregnant women with cer-vical incompetence(r=0.109,P=0.081).Among the 376 pregnant women,79 cases were spontaneous preterm delivery(21.01％),and 297 cases were full term delivery(78.99％).79 spontaneous preterm pregnant women were divided into preterm birth group,and the remaining 297 full-term pregnant women were divided into non-term birth group.Univariate analysis showed that there was no statistically signifi-cant difference in age,BMI,number of abortions,pregnancy with assisted reproductive technology and gestational week between the 2 groups(P＞0.05).Compared with non-preterm preterm pregnant women,ACA in the preterm preterm pregnant women was higher.CL and SWV were decreased(P＜0.05).Logistic analysis confirmed that ACA,CL and SWV were important risk factors for spontaneous preterm delivery in pregnant women with cervical imfunction(P＜0.05).The combined prediction model for preterm birth was established:Logistic(P)=-48.126+6.059X SWV+0.206 X CL+0.295 X ACA.ROC curve analysis showed that the independent prediction sensitivity of ACA,CL and SWV for sponta-neous causes of cervical imfunction in pregnant women was 82.90％,68.30％and 80.50％,respectively,while the combined prediction sensitivity of ACA+CL+SWV was 93.90％.Conclusion ACA,CL and SWV have certain predictive value in the risk of spontaneous preterm delivery in pregnant women with cer-vical imfunction,and the combined prediction sensitivity and accuracy of each index are high,which is con-ducive to reducing the risk of missed diagnosis or misdiagnosis to the greatest extent.
cervical incompetencespontaneous premature birthshear wave velocitycervical lengthan-terior horn of cervix
万方数据
维普
