论文部分内容阅读
目的:探讨不同子宫颈长度、不同诊断孕周的单胎妊娠短子宫颈孕妇，接受不同方式治疗后妊娠结局的差异并分析其影响因素。方法:收集2018年1月1日至12月31日于北京大学第一医院妇产科产前检查，妊娠12~33周n +6超声检查诊断为短子宫颈（≤25 mm）的单胎妊娠孕妇435例的临床资料，进行回顾性队列分析。435例短子宫颈孕妇中，子宫颈长度0.05）。感染是早产的独立危险因素（n OR=56.40，95%n CI为4.67~680.61，n P=0.002）。（5）子宫颈长度≥10 mm且诊断孕周≥30周的223例短子宫颈孕妇中，孕34周前分娩率为6.3%（14/223），妊娠结局良好。各治疗组的分娩孕周、孕37周前分娩率、孕34周前分娩率、新生儿出生体重和新生儿不良结局分别比较，差异均无统计学意义（n P均>0.05）。感染（n OR=10.91，95%n CI为2.21~53.96，n P=0.003）和早产史（n OR=8.63，95%n CI为1.25~59.65，n P=0.029）是早产的独立危险因素。n 结论:短子宫颈是妊娠期较常见的并发症，子宫颈长度0.05) among rest group (n n=36), progesterone group (n n=26) and cerclage group (n n=34). In vitro fertilization (n OR=11.97, 95%n CI: 1.88-76.44, n P=0.009), infection (n OR=46.03, 95%n CI: 5.12-413.58, n P=0.001), sludge on sonography (n OR=9.87, 95%n CI: 1.69-57.60, n P=0.011) and history of short cervix (n OR=7.24, 95%n CI: 1.04-50.24, n P=0.045) were independent risk factors of preterm birth. (4) In the group of cervical length ≥10 mm and gestational weeks between 24-29n +6, the delivery weeks, incidence of delivery before 37 weeks, incidence of delivery before 34 weeks, NBW and ANO were not statistically different (n P>0.05) among rest group (n n=52), progesterone group (n n=34) and cerclage group (n n=9). Infection was an independent risk factor of preterm birth (n OR=56.40, 95%n CI: 4.67-680.61, n P=0.002). (5) Outcomes of 223 cases were relatively good in the group of cervical length ≥10 mm beyond 30 gestational weeks. The incidence of delivery before 34 weeks was 6.3% (14/223). The delivery weeks, incidence of delivery before 37 and 34 weeks, NBW and ANO were not statistically different (n P>0.05) among 3 groups. Infection (n OR=10.91, 95%n CI: 2.21-53.96, n P=0.003) and history of preterm birth (n OR=8.63, 95%n CI: 1.25-59.65, n P=0.029) were independent risk factors of preterm birth.n Conclusions:Short cervix is a common complication of pregnancy. Cervical cerclage is related with better outcome for patients with cervical length 10 mm cervical length patients comparing with rest. Infection, sludge, in vitro fertilization, history of short cervix and history of preterm birth are independent risk factors of preterm birth in short cervix pregnancies.