Predictive value of transvaginal ultrasound for detecting cervical length and morphology in premature rupture of membranes in high-risk pregnant women / 中国基层医药

ABSTRACT

Objective:To explore the predictive value of cervical length and morphology detected by transvaginal ultrasound in the diagnosis of premature rupture of membranes in high-risk pregnant women.Methods:From January 2014 to October 2018, 150 high-risk pregnant women admitted to Pingyang Hospital Affiliated to Wenzhou Medical University were divided into two groups according to whether premature rupture of membranes occurred.In the control group, 91 cases of premature rupture of membranes did not occur.In the observation group, 59 patients had premature rupture of membranes.The differences in cervix shortening, cervical length and funnel shape of the cervix were compared between the two groups.The differences in specificity and sensitivity between different cervical lengths and funnel-like changes were observed.Results:The cervical shortening, cervical length and funnel-shaped number in the observation group were (16.9±2.1)weeks, (13.7±6.9)mm and 37 cases(62.71%), respectively, which in the control group were (20.2±2.8)weeks, (18.3±8.0)mm and 40 cases(43.96%), respectively, the differences were statistically significant( t=9.268, 6.056, χ 2=5.297, all P<0.05). The predictive value of transvaginal ultrasound for the sensitivity of cervical length<10 mm and funnel shape>75% was too low, but the specificity was high(91.20% and 95.00%). The sensitivity and 95% confidence interval for cervical length<20 mm were 61.54%, 0.8~4.4, respectively.The sensitivity and 95% confidence interval of cervical length<15 mm were 43.59% and 0.9~6.5, respectively.The sensitivity and 95% confidence interval of funnel shape>25% were 84.62% and 0.3~3.5, respectively.The sensitivity and 95% confidence interval of funnel shape>50% were 43.59% and 0.7~7.2, respectively.In the control group, there was no cervical length<10 mm and funnel shape>75%.The sensitivity of cervical length<20 mm was 61.54%, the 95% confidence interval was 0.2~3.0.The sensitivity of funnel shape>25% and the 95% confidence interval were 44.29% and 0.3~3.8, respectively. Conclusion:For cervical length<10 mm, funnel morphology>75% has excellent predictive value for premature rupture of membranes, which is the main reason for maternal preterm birth.