Ultrasound Assessment Of Cervical Morphology In The Second And Third Trimester Of Pregnancy To Predict Pregnancy Outcome

Objectives: Transvaginal ultrasound and transperineal ultrasound were used to observe the morphology of the cervix and measure related parameters,and to explore the clinical value of ultrasound in assessing the length and morphology of the cervix in the middle and late stages of pregnancy and to predict the outcome of pregnancy.Methods:A total of 360 pregnant women who underwent routine prenatal examination and no obvious uterine cavity disease at the Fourth Affiliated Hospital of Nanchang University from January 2018 to December 2019 were selected as the research subjects,aged 20 to 42 years,with an average age of(27.6 ± 3.3)years.The gestational week was 24 to 36 weeks,with an average(29.5 ± 3.5)weeks.The ultrasonic diagnostic instrument used is the Philips EPIQ5 color Doppler diagnostic instrument.The transvaginal examination uses an intracavity probe with a probe frequency of 3.0 to 10.0 MHz.The transperineal examination uses a convex array probe with a probe frequency of 3.5 to 5.0 MHz.Transvaginal ultrasound examinations were performed at 24,28,and 32 weeks of pregnancy,and transperineal ultrasound examinations were performed at 36 weeks to observe the morphology of the cervical mouth of pregnant women,measure the cervical length,and calculate the cervical index(CI),and record the morphology of the internal cervix.All pregnant women were followed up to the end of pregnancy.According to the results of follow-up,all pregnant women were divided into premature delivery groups(pregnancy weeks <37 weeks)and term delivery groups(pregnancy weeks ? 37 weeks)according to the fetal delivery week.SPSS 22.0 statistical software was used to analyze and process the data,and compare the cervix mouth shape,cervical length and cervical index in the preterm and full-term delivery groups.Results:The cervical length of pregnant women in the preterm and full-term labor groups decreased with the increase of the gestational week.The length of the cervix in the preterm birth group at 24,28,32 and 36 weeks was significantly shorter than that of the full-term delivery group,and the difference was statistically significant(P <0.05).The cervix index of each gestational week in the preterm birth group was larger than that in the term delivery group,and the difference was statistically significant(P <0.05).The length of the cervical canal was measured at 24 weeks of pregnancy.Among 360 cases,242 cases were ?3.0 cm,of which 98 cases occurred premature,with a sensitivity of 89.9%,a specificity of 42.6%,a positive predictive value of 40.5%,and a negative predictive value of 90.7%;80 cases were ? 2.5cm,of which 70 cases had premature delivery,with a sensitivity of 64.2%,specificity of 96%,a positive predictive value of 87.5%,and a negative predictive value of 86.7%;in 20 cases ? 2.0cm,preterm birth occurred,with a sensitivity of 18.3%,a specificity of 100%,and a positive The predicted value was 100% and the negative predicted value was 73.8%.Among 360 pregnant women,there were 256 cases with a normal internal cervix shape,of which 37 cases had premature delivery,with a premature delivery rate of 14.45%;104 cases of funnel formation of the internal cervix mouth,including 59 cases of "V" type and 34 cases of premature delivery Premature birth rate was 57.62%;45 cases of "U" type had premature birth,and the premature birth rate was 100%.The premature birth rate of pregnant women with normal morphology of the cervix is lower than those with cervical funnel formation(P <0.05),and the "U" shape of the cervix is more likely to produce preterm birth than the "V" shape.Significance(P <0.05).Conclusion:1.Ultrasound measurement of CL is feasible,and relying on its non-invasive,safe,and reproducible advantages,it can be used to dynamically assess CL and cervical morphological changes during pregnancy,provide a reference for early clinical assessment of preterm birth risk,reduce premature birth of newborns,and improve their survival rate.2.Cervical length decreases with increasing gestational week.The cervical length of pregnant women in the premature group were significantly lower than those of the normal delivery group,and CI was significantly higher than that in the normal delivery group.The cervical canal length is measured at 24 weeks of pregnancy,and the prediction of premature birth with a cervical canal length of ?25 mm has a good diagnostic effect.Such pregnant women have a higher probability of premature birth.In the middle and late pregnancy,follow-up of their cervix should be strengthened,early signs of premature birth should be detected,and effective treatment measures should be given to reduce premature birth.3.The length of the cervix and the formation of the funnel inside the cervix are interrelated.The shorter the closed length of the cervix,the more obvious the formation of the funnel inside the cervix.When the funnel is formed,the risk of premature birth increases,especially when the cervical canal is U-shaped.