Cervical stiffness in mid-pregnancy: a predictive tool using a novel aspiration device for spontaneous preterm birth risk assessment

IF 3.6 2区医学 Q1 OBSTETRICS & GYNECOLOGY

American Journal of Obstetrics & Gynecology Mfm Pub Date : 2026-02-01 Epub Date: 2025-12-05 DOI:10.1016/j.ajogmf.2025.101867

Irene Hösli MD, PhD, Gundula Hebisch MD, Michael Bajka MD, Katharina Quack Lötscher MPH MD, Alice Winkler MD, Leonhard Schäffer MD, PhD, Begoña Martinez de Tejada MD, PhD, Monya Todesco Bernasconi MD, Tina Fischer MD, Vincent Uerlings MD, Jute Richter MD, PhD, Stephanie Von Orelli MD, Markus Kuther MD, Elke Prentl MD, Ursula Fellmann MD, Alexander Krafft MD, Lea Köchli MD, Sabrina Badir DSc, David Scheiner MD

引用次数: 0

Abstract

Video Abstract

Download: Download video (3MB)

查看原文本刊更多论文

妊娠中期颈椎僵硬：使用新型吸吸装置进行自发性早产风险评估的预测工具。

目的：目前的早产（PTB）风险评估标准是经阴道超声测量宫颈长度。acl 1,2。宫颈软化一直被认为是妊娠期间宫颈状态的重要描述参数，由于技术的进步，它重新被认为具有改善自发性PTB （sPTB）风险评估的潜力。在这项研究中，我们评估了妊娠中期用基于吸气的妊娠系统4测量的宫颈僵硬度在最终足月分娩的孕妇和自然早产的孕妇之间的差异；我们评估了刚度在预测sPTB中的性能。研究设计：我们在13个中心对18-55岁的孕妇进行了一项横断面、前瞻性、队列研究（NCT02037334）。临床人群包括在常规妊娠中期咨询（妊娠180/7 - 220/7周）能够给予知情同意的妇女。排除和退出标准为活动性出血，膜早破（PROM），活动性生殖器感染，已知HIV或乙型或丙型肝炎携带者，前置胎盘，勒氏管异常，已知或疑似研究不符合，药物或酒精滥用，环扎或子宫托，以及CL 4。通过最大宫颈压缩性比（宫颈一致性指数，CCI）和经阴道测量的宫颈长度来确定刚度。疼痛或不适评分（0 -无疼痛至10 -最大可能疼痛），并记录分娩信息。结果：在1002名入组妇女中，990名为单胎妊娠。整个数据集的早产率（5.2%）大大低于预期，52例早产中有25例是自然发生的。单胎妊娠发生sPTB的妇女妊娠中期平均CSI（中位数=65 mbar， IQR=(41,70), n=19）显著低于足月分娩的妇女（71 mbar, (51,97), n=948）。CL和CCI无显著差异（见表1）。先前阴道分娩（VD）与宫颈柔软密切相关：在足月单胎妊娠中，有VD的妇女（64 mbar, (45,85), n=358）的CSI比没有VD的妇女（75 mbar, (55,103), n=590）的CSI低15%(结论：自然早产的单胎妊娠妇女的颈椎僵硬度明显低于足月分娩的妇女。这一发现与其他方法的文献结果一致，表明可以在宫颈阴道暴露部分评估颈椎僵硬度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American Journal of Obstetrics & Gynecology Mfm Medicine-Medicine (all)

CiteScore

7.40

自引率

3.20%

发文量

254

审稿时长

40 days

期刊介绍： The American Journal of Obstetrics and Gynecology (AJOG) is a highly esteemed publication with two companion titles. One of these is the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine (AJOG MFM), which is dedicated to the latest research in the field of maternal-fetal medicine, specifically concerning high-risk pregnancies. The journal encompasses a wide range of topics, including: Maternal Complications: It addresses significant studies that have the potential to change clinical practice regarding complications faced by pregnant women. Fetal Complications: The journal covers prenatal diagnosis, ultrasound, and genetic issues related to the fetus, providing insights into the management and care of fetal health. Prenatal Care: It discusses the best practices in prenatal care to ensure the health and well-being of both the mother and the unborn child. Intrapartum Care: It provides guidance on the care provided during the childbirth process, which is critical for the safety of both mother and baby. Postpartum Issues: The journal also tackles issues that arise after childbirth, focusing on the postpartum period and its implications for maternal health. AJOG MFM serves as a reliable forum for peer-reviewed research, with a preference for randomized trials and meta-analyses. The goal is to equip researchers and clinicians with the most current information and evidence-based strategies to effectively manage high-risk pregnancies and to provide the best possible care for mothers and their unborn children.