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임신 38주 초음파검사에 의한 일주일 이내의 분만가능성 예측
노현경 ( Hyun Kyung Rho ),이선경 ( Sun Kyung Lee ),차지영 ( Ji Young Cha ),조태일 ( Tae Il Cho ),김광준 ( Gwang Jun Kim ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.12
Objective: The aim of this study is to predict spontaneous labor onset delivery within 7 days in low risk pregnant women at 38 weeks` of gestation by ultrasonographic examination of cervical changes. Material & Methods: This prospective study included 110 singleton low risk pregnancies between 37+0 and 37+6 weeks of gestation. Fifteen cases were lost during follow-up and finally 95 pregnant women (58 nulliparous, 37 multiparous) were analysed. The study period was from Oct/2005 to May/2007. Four cervical changes (length, gland thickness, funneling and canal formation) were evaluated. Main outcome was remaining day to delivery after the examination. Remaining days to actual delivery with spontaneous labor onset were recorded and the pregnancies were divided into two groups according to remaining days (within 7 days, over 7 days) to compare predicting power of delivery within 7 days. ROC curves were drawn to find out cut-off values of cervical length and gland thickness. Sensitivity, specificity, positive predictive value and negative predictive value were extracted from four cervical changes. Resullts: Mean cervical length of pregnant women at 38 weeks` of gestation was 25.8 (±10.0) mm and mean cervical gland thickness was 4.3 (±1.2) mm. Funnelings of uterine cervix were detected in 13 cases (13.7%), canal formations in 6 cases (6.3%). All four cervical changes were statistically valuable to predict delivery within 7 days and the cervical length showed highest sensitivity. When the cervical length was measured under 20 mm, the possibility of delivery within 7 days was 78.6% (p<0.001). The cervical gland thickness less than 4 mm could predict the delivery within 7 days with sensitivity of 57.1% (p<0.01). Sensitivities of funneling and canal formation for delivery within 7 days were 54.5%, 36.4% each. Conclusion: Ultrasonographic examination of the cervical changes in low risk singleton pregnancy at 38 weeks` of gestation are valuable for predicting spontaneous labor onset delivery within 7 days. Among four cervical changes, cervical length is most sensitive ultrasonographic marker.
김광준 ( Gwang Jun Kim ),이은실 ( Eun Sil Lee ),이우석 ( Woo Seok Lee ),이상훈 ( Sang Hoon Lee ),장영진 ( Young Jin Jang ),김동호 ( Dong Ho Kim ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.7
Objective: The aim of this study was to find out the relating factors with the actual delivery day in term singleton pregnancy. Methods: The 52 patients with singleton gestation were visited weekly and measured for their lower uterine segment (LUS) thickness, cervical length and cervical gland thickness by transvaginal ultrasonography and for amnionic fluid index (AFI) by transabdominal ultrasonography from 36 weeks of gestation until birth. Regression analysis was used to find out the relevance between these factors and remaining days to birth. Resullts: There was a significant relationship between cervical length and remaining days to birth in term pregnancy, which could be described as a mathematical equation (remaining days for delivery=6.12+0.24×cervical length (㎜) r=0.29, p<0.01). However, no relationship was found between factors such as LUS, AFI, and cervical gland thickness and remaining days to birth. Conclusion: Our results suggest that the actual delivery day in term singleton pregnancy might be predicted with cervical length.