中国实用妇科与产科杂志

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宫颈机能不全的孕期诊断及评价

张向丽   

  1. 作者单位:山东大学齐鲁医院妇产科,山东 济南250012
  • 出版日期:2014-02-02 发布日期:2014-01-23

Diagnosis and evaluation of cervical incompetence during pregnancy.

ZHANG Xiang-li   

  1. Department of Obstetrics and Gynecology,Qilu Hospital of Shandong University,Jinan 250012,China
  • Online:2014-02-02 Published:2014-01-23

摘要:

宫颈机能不全(cervical incompetence,CIC)孕期诊断主要依靠:既往病史和临床症状、阴道检查、超声检查结果;对CIC的诊断通常仅限于单胎妊娠。至少两次28周前的妊娠流产(无痛性宫颈扩张)病史可作为CIC诊断的独立指标;在妊娠24周前的初产妇或经产妇(无多次流产史的),当阴道超声提示其宫颈长度﹤25 mm和(或)查体时发现宫颈有进行性的变化,结合一次以上的14-36周妊娠流产(或早产史)或明确的CIC发生高危因素可以作出CIC的诊断。

关键词: 宫颈机能不全, 无痛性宫颈扩张, 宫颈长度, 阴道超声

Abstract:

Abstract:The diagnosis of cervical incompetence(CIC)during pregnancy mainly is based both on clinical findings (cervical characteristics, ultrasound studies)and on the previous history of the patient. Diagnosis of cervical incompetence is usually limited in single pregnancy. Using historic factors alone, cervical insufficiency is defined as painless cervical dilatation leading to recurrent second trimester pregnancy losses/births(at least twice) before 28 weeks of gestation have occurred. Cervical insufficiency is diagnosed by TVU cervical length<25 mm and/or advanced cervical changes on physical examination before 24 weeks of gestation in primigravidas or in multigravidas(without multiple prior pregnancy losses)with either:one or more prior pregnancy losses or preterm births at 14 to 36 weeks,and/or other significant risk factors for cervical insufficiency.

Key words: cervical incompetence, painless cervical dilatation, cervical length, transvaginal ultrasound

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