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Objective:To investigate the normal parameter values of transvaginal E-Cervix cervical elastography of primipara and explore the correlation between E-Cervix parameters and gestational age.Methods:A total of 301 primiparas underwent E-Cervix by transvaginal ultrasound in Henan Provincial People′s Hospital from March 2019 to January 2021, they were divided into 6 groups according to generational weeks: group A (11-13 + 6W), group B (14-17 + 6W), group C (18-21 + 6W), group D (22-25 + 6W), group E (26-29 + 6W), group F (30-33 + 6W). Real-time E-Cervix parameters were obtained, including elasticity contrast index (ECI), hardness ratio (HR), internal ostium (IOS), and external ostium (EOS), strain ratio of the internal and external cervical ostium (IOS/EOS), and the correlations between E-Cervix parameters and the gestational week were analyzed. Results:The normal reference ranges of parameters ECI, IOS, EOS, HR and IOS/EOS were obtained, their 95% reference values in groups A to F were as follows: ECI (1.84-3.38, 2.13-4.50, 2.25-4.12, 2.06-3.96, 2.04-5.15, 2.36-5.53), HR (85.85%-88.72%, 77.31%-80.92%, 74.41%-78.50%, 71.13%-74.35%, 64.49%-68.56%, 63.57%-68.23%), IOS (0.12-0.21, 0.14-0.34, 0.14-0.31, 0.19-0.40, 0.19-0.56, 0.21-0.49), EOS (0.12-0.30, 0.14-0.34, 0.16-0.41, 0.20-0.39, 0.22-0.58, 0.22-0.54), IOS/EOS (0.55-1.12, 0.52-1.45, 0.56-1.26, 0.54-1.38, 0.54-1.52, 0.65-1.46). The differences of ECI, HR, IOS and EOS in different groups were statistically significant (all P<0.05). Spearman correlation analysis results showed that ECI, IOS, and EOS were positively correlated with gestational week( rs=0.524, 0.689, 0.609; all P<0.01). HR was negatively correlated with gestational week ( rs=-0.755, P<0.01). The regression equations of ECI, HR, IOS and EOS were Y=0.06X+ 52.214, Y=99.25-1.07X, Y=8.63E-3X+ 0.05, Y=7.94E-3X+ 0.1, respectively. Conclusions:The normal parameters values of E-TVES are summarized.It provides effective support in data for cervical evaluation in the preterm prediction and success of labor induction.
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Objective:To explore the relationship between different gestational weeks of transvaginal ultrasound-guided fetal reduction and abortion in patients with multiple pregnancies after embryo transfer, and to seek the best gestational age for fetal reduction.Methods:The datas of 486 pregnant women with multiple pregnancies after embryo transfer in the Second Hospital of Hebei Medical University from January 2012 to December 2020 were retrospectively analyzed. The relationship between gestational weeks of fetal reduction and abortion rate was analyzed by curve fitting, threshold effect and multivariate logistic regression analysis.Results:After adjusting for age, infertility type, infertility years, number of births, abortion times, body mass index(BMI), various infertility and sterility factors, endometrial thickness on the day of transformation, monozygotic twins and reduction methods, when the gestational age was less than 8.43 weeks, the abortion rate increased significantly with the increase of reduction gestational age, and the abortion rate increased by 221% ( OR=3.21, 95% CI=1.47-6.99, P=0.003 3). When the gestational age of reduction ≥8.43 weeks, the abortion rate tended to be stable and did not increase ( OR=0.81, 95% CI=0.54-1.22, P=0.317 7); meanwhile, in stratified analysis, the OR value of the BMI ≥24 kg/m 2 was 12.38, and that of BMI <24kg/m 2 was 1.91, P=0.053 9. Conclusions:There is a non-linear relationship between gestational age and abortion rate of ultrasound-guided multiple pregnancy reduction in patients with embryo transfer. The abortion rate increases significantly with the increase of gestational age before 8.43 weeks of gestation. It is recommended to carry out the operation as early as possible before 8 weeks of pregnancy. The effect of BMI on the abortion rate of patients with fetal reduction needs further study.
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To evaluate and discuss feasibility and value of the transvaginal two‐dimensional sonography in distinguishing the major muscle groups of levator ani ,including puborectalis and iliococcygeus ,by observing the morphology and contraction form of these muscles . Methods Total of 145 nulliparous women were chosen . T he major muscle groups of levator ani were observed by transvaginal two‐dimensional sonography . T he images of puborectalis and iliococcygeus were obtained both at rest and contracting . T he features of the sonogram and the direction of muscle contraction were summarized . T he consistency between two sonographers was analyzed by ICC . Results T ransvaginal two‐dimensional sonography could be used to observe and distinguish the major muscle groups of levator ani . Puborectalis was showed distinctly as thick and uniform hyperechoic linear zone . Iliococcygeus was showed as triangle zone with sparse hyperechoic lines ,with one angle pointing to the caudal .During contracting ,puborectalis moved from the dorsal to the ventral while iliococcygeus contracted from the caudal to the cephalic . T he consistency between two sonographers for distinguishing the morphology and contraction form between the puborectalis( ICC＝0 .93 ,0 .89 ) and ilococcygeus ( ICC＝0 .78 ,0 .75 ) were remarkably high . Conclusions T ransvaginal two‐dimensional sonography could be used to observe dynamically and distinguish the morphology and contraction form of the levator ani muscles ,including puborectalis and iliococcygeus . It is a convenient and reproducible method to help study mechanism of levator ani injury and provide fine radiological evidence of making individual treatment .
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Objective To explore the diagnostic value of comparing enhanced transvaginal ultrasound (E-TVS),none enhanced transvaginal ultrasound (TVS),and transrectal ultrasound (TRS) in preoperative detection of deep infiltrating endometriosis (DIE) in the rectosigmoid by Meta-analysis.Methods The literatures published from January 1990 to June 2016 were searched.The information of literatures were selected and evaluated.The included data was statistically analyzed by Meta-disc 1.4 software.Results Totally 25 literatures were enrolled.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio were 0.92,0.96,16.64,0.09,227.95 for E-TVS,0.83,0.97,16.95,0.17,112.97 for TVS,0.94,0.96,14.43,0.08,208.72 for TRS,respectively.Area under the curve were 0.980 4,0.966 3,0.979 0,respectively.Conclusion Diagnostic value of the three ultrasonography in preoperative detection of DIE in the rectosigmoid are E-TVS,TRS,TVS.E-TVS can be used as the preferred method of ultrasonic diagnosis of DIE in the rectosigmoid.