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Purpose applications cervical secretions high phosphorylation of the insulin-like growth factor binding protein -1 (phosphorylated insulin-like growth factor-binding protein-1 phIGFBP-1), abdominal and vaginal ultrasound detection of cervical length joint preterm high-risk pregnant women predicting preterm evaluation Analysis. In July 2008 August -2009 pregnant women in hospital maternity outpatient prenatal check screened 87 cases of premature delivery high-risk pregnant women with intact membranes broken, vaginitis. The selected object First line abdominal ultrasound detect cervical length (cervical length, CL), and then detected high phosphorylation of the insulin-like growth factor binding protein-1 levels in cervical secretions, simultaneously leucorrhea routine of bacterial vaginosis reproductive tract infections detection . As abdominal ultrasound detect cervical length ≤ 3.5cm, further line to vaginal ultrasound detect cervical length, accurate records of gestational age and cervical length measurement, tracking, follow-up of pregnancy outcomes (not in my hospital childbirth telephone follow-up). Final delivery situation, the test subjects were divided into preterm group and term delivery groups. The results of the application SPSS16.0 χ ~ 2 test, logistic regression analysis, independent samples t test, analysis of variance, statistically, the mean (?) ± S. P lt; 0.05 considered statistically significant. The results (1) the preterm group phIGFBP-1-positive rate of 38.89% (7/18), the full-term group phIGFBP-1 positive rate of 10.61% (7/66), the difference was significant (P lt; 0.01). The the cervical secretions phIGFBP-1 to predict the sensitivity of preterm birth by 50% (7/14), specificity of 89.39% (59/66), the positive predictive value of 50% (7/14), and the negative predictive value of 84.29% (59/70 ). CL ≤ 4.0cm in 48 cases (2) transabdominal measurement, its preterm birth rate was 29.17% (14/48), significantly higher than the CL of ≥ 4.0cm group of pregnant women rate of preterm birth, preterm birth rate was 11.11% (4/36) (P lt; 0.01). Abdominal ultra-CL ≤ 4.0cm predict preterm birth sensitivity of 77.8% (14/18), specificity of 48.48% (32/66), the positive predictive value of 29.17% (14/48), and a negative predictive value of 88.89% (32/36 ). (3) measured vaginal CL ≤ 2.5cm in seven cases, the preterm birth rate was 85.7% (6/7) was significantly higher than CL> 2.5cm rate of preterm birth in pregnant women, the preterm birth rate was 15.58% (12/77) ( P lt; 0.01). Yin Chao CL ≤ 2.5cm predict preterm birth sensitivity of 33.3% (6/18), specificity of 98.48% (65/66), the positive predictive value of 85.71% (6/7), negative predictive value of 84.42% (65/77 ). (4) of 20 patients with abdominal ultra-CL ≤ 3.5cm, the overcast ultra cervical length was measured, results of abdominal ultra cervical length was 3.02 ± 0.30cm, Yin super cervical length was 2.68 ± 0.31 cm, the former is significantly larger than the latter ( P lt; 0.05). Abdominal ultra, overcast Value correlation analysis, found between close correlation (r = 0.5676, P lt; 0.001). (5) The subject of the preterm group, the term delivery group and all subjects were divided into pregnancy 24 to 28 weeks, 28 to 32 weeks, 32 to 37 weeks gestational age group, more than three weeks of gestation group abdomen super cervical length by univariate analysis of variance the display group difference was not statistically significant, P gt; 0.05. (6) combined with abdominal ultra-CL ≤ 4.0cm and cervical secretions phIGFBP-1 predict the sensitivity of preterm birth, 38.89% (7/18), specificity of 66.67% (44/66), the positive predictive value of 58.33% (7/12 ), negative predictive value was 91.67% (44/48). Yin Chao CL ≤ 2.5cm combined phIGFBP-1 predict preterm delivery occurred sensitivity 5.56% (1/18), specificity of 84.85% (56/66), the positive predictive value of 50% (1/2), and the negative predictive value of 87.5% (56/64). (7) pregnant women age pregnancies, number of abortions, cervical length, phIGFBP-1 and other factors logistic regression analysis, the results showed that the cervical length and phIGFBP-1 are the independent risk factors for preterm birth. Abdominal ultra cervical length and cervical secretions phIGFBP-1 between the positive correlation, the correlation coefficient r = 0.25 (P = 0.018), cervical length shorter phIGFBP-1 detection is also more positive. Conclusion (1) cervical length and phosphorylated IGFBP-1 are independent risk factors for preterm birth, are closely related with the occurrence of preterm labor, preterm birth prediction can be used as an objective indicators. (2) United cervical secretions high phosphorylated IGFBP-1 and cervical length preterm prediction can improve the positive predictive value and negative predictive value, that is, when the preterm birth Yin Chao CL ≤ 2.5cm, 85.71% of patients, the need to strengthen monitoring active treatment, to reduce the incidence of preterm birth; phIGFBP-1 tested negative abdominal ultra-CL gt; 4cm, 91.67% of the patients with term delivery, reduce unnecessary obstetric intervention. (3) ultrasound detection of cervical length could predict preterm birth preterm birth risk pregnant women significance, not transvaginal detection of preterm prediction transabdominal measurement of cervical length with some help.
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