Abstract Objective: To investigate the predictive value of cervical heterogeneity by ultrasound for spontaneous premature delivery (sPTB) of pregnant women. Methods: 418 pregnant women were included in this study from July 2017 to December 2018. A new quantitative marker was calculated by using matrix model to reflect the heterogeneity index (HI) of cervical collagen fibers relative to cervical tissues, and its diagnostic value for sPTB was evaluated. Results: 116 (28.2%) women with sPTB in the 418 pregnant women were included in group A and 302 (72.2%) women with full-term delivery were included in group B. There were no significant different in age, gestational weeks when delivery, and cesarean section rate of women between the two groups (P>0.05). The proportion of sPTB history of women in group A was significant higher than that of women in group B, but the gestational weeks when delivery, neonatal weight, HI and cervical length of women in group A were significant lower (P<0.05). ROC curve analysis showed that the optimum critical point of HI for predicting sPTB was 13.7. When HI was 13.7, the sensitivity, the specificity, and the area under curve of HI predicting sPTB were 90.2%, 60.3% and 0.817, respectively. Multivariate logistic analysis showed that sPTB history, cervical length, and HI were risk factors for sPTB (OR 2.38, 95% CI: 2.17-2.76), but cervical length and HI were protective factors for sPTB (OR 0.87, 0.47; 95% CI: 0.83-0.94, 0.28-0.53). Conclusion: Cervical HI is an indicator for evaluating the cervical microstructural changes, which maybe help to identify pregnant women with sPTB before their cervical length measurements reflect macrostructural changes.
|
|
|
|
|
|
