Predictive value of detect cervical length and funnel-like changes by transvaginal ultrasonography to predict whether preterm premature rupture of the membrane would occured or not in high risk gravida of preterm premature rupture of the membranes

Abstract

Objective To discuss detect cervical length and funnel-like change for preterm premature rupture of the membranes(PPROM) high-risk pregnant women by transvaginal ultrasonography(TVS)to predict the occurrence of PPROM. Methods A total of 68 cases of PPROM high-risk pregnant women hospitalized in Tianjin Central Hospital of Gynecology Obstetrics from June 2009 to December 2013 were selected as study subjects, according to whether PPROM occurred or not after admission, they were divided into PPROM group(n=28) and non PPROM group(n=40). All subjects were given TVS to detect cervical length and the occurrence of cervical funnel-like changes, statistically analyzed the differences of cervical length and cervical funnel-like change rate of pregnant women between two groups, and the accuracy of different cervical length and funnel-like change to predict occurrence of PPROM and the relationship with PPROM occurrence. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Tianjin Central Hospital of Gynecology Obstetrics.Informed consent was obtained from each participant.There were no significant differences between two groups in general clinical data such as maternal age, pre-pregnant body weight and gestational age(P>0.05). Results ①Cervical length of pregnant women of PPROM group was significantly shorter than that of non PPROM group, the cervical funnel-like change rate was significantly higher than that of non PPROM group, and the differences were statistically(t=2.273, 5.909; P<0.05). ②With the length of cervical getting shorter and cervical funnel-like change rate getting higher, the prediction specificity and positive predictive value of PPROM increased gradually, and cervical length<5 mm or 75%<funnel-like change rate≤100% had highest prediction specificity of PPROM (97.2% and 96.3%) and positive predictive value(79.6% and 76.3%), they had the closest relationship with PPROM occurrence(OR=6.47, 95%CI: 1.33-38.21, P<0.05; OR=5.80, 95%CI: 1.11-30.22, P<0.05). Conclusion TVS detecting cervical length and cervical funnel-like change can effectively predict the occurrence of PPROM of high risk PPROM pregnant women; Cervical length 75% have the highest prediction value of PPROM occurrence. Key words: Transvaginal ultrasonography; Preterm premature rupture of the membranes; Cervix uteri; Forecasting