摘要目的：探讨超声测宫颈长度预测早产的临床意义，并对经腹、经阴道与经会阴三种超声途径测宫颈长度预测早产进行比较。方法对2012年1月至2013年12月有先兆早产征象来本院就诊的孕妇（840例）行超声测宫颈长度预测早产，按不同测量宫颈长度途径分为3组，每组280例，经腹测量宫颈长度（Ⅰ组）、经阴道测量宫颈长度（Ⅱ组）、经会阴测量宫颈长度（Ⅲ组），记录宫颈长度（ CL ），追踪妊娠结局，并对三种测量方法进行比较。结果Ⅰ组孕妇接受率为100％（280/280），宫颈实现率为85.0％（238/280），CL＜3 cm组早产率为48.6％（18/37），CL≥3 cm组早产率为17.9％（36/201），CL＜3 cm预测早产敏感性为33.3％（18/54）；Ⅱ组孕妇接受率为81.8％（229/280），宫颈实现率为98.7％（226/229），CL＜3 cm组早产率为37.8％（28/74），CL≥3 cm组早产率为13.2％（20/152），CL＜3 cm预测早产敏感性为58.3％（28/48）；Ⅲ组孕妇接受率为99.3％（278/280），宫颈实现率为98.2％（273/278），CL＜3 cm组早产率为37.1％（33/89），CL≥3 cm组早产率为13.6％（25/184），CL＜3 cm预测早产敏感性为56.9％（33/58）。三组CL＜3 cm组早产率（48.6％，37.8％，37.1％）均明显高于CL≥3 cm组早产率（17.9％，13.2％，13.6％），差异有统计学意义（ P ＜0.05）。Ⅱ组孕妇接受率（81.8％）明显低于Ⅰ组（100％）和Ⅲ组（99.3％），差异有统计学意义（ P ＜0.05）。Ⅰ组宫颈实现率85％明显低于Ⅱ组98.7％和Ⅲ组98.2％，差异有统计学意义（ P ＜0.05）；Ⅰ组CL＜3 cm预测早产敏感性33.3％，明显低于Ⅱ组（58.3％）和Ⅲ组（56.9％），差异有统计学意义（ P ＜0.05）。结论超声测宫颈长度预测早产有较大临床意义，相比之下经会阴途径更具优势，值得推广。

abstractsObjective To compare three ultrasonic methods of transabdominal , transvaginal , and transperineal ultrasonogra-phy for the cervical length ( CL) in predicting the preterm birth .Methods The pregnancy women with threatened preterm labor in Hunan Provincial Hospital of Maternal and Child Health from January , 2012 to December, 2013 were chosen to measure the cervical length by sonography , and were randomly divided into three guoups ( 280 pregnancy women in each group ) , including Group Ⅰ( transabdominal ) , groupⅡ( transvaginal ) , and group Ⅲ ( transperineal ) .The cervical length and the pregnancy outcome were fol-lowed up.Results The acceptance rate of group Ⅱ(81.8%=229/280) was significantly lower than that of groupⅠ(100%=280/280)and group Ⅲ(99.3%=278/280)( P <0.05).The realization ratio of the cervix in group Ⅰ(85.0%=238/280) was signifi-cantly lower than that of group Ⅱ(98.7%=226/229) and group Ⅲ (98.2%=273/278) ( P <0.05).The preterm birth rate of 48.6%(18/37) in groupⅠ, 37.8%(28/74) in groupⅡ, and 37.1%(33/89) in groupⅢin the pregnancy women with CL <3 cm was significantly higher than the corresponding preterm birth rate of 17.9%(36/201) in groupⅠ, 13.2%(20/152)in groupⅡ, and 13.6% (25/184) in groupⅢin the pregnancy women with CL≥3 cm.The sensitivity of groupⅠ(33.3%=18/54) was significantly lower than that of group Ⅱ(58.3%=28/48) and group Ⅲ(56.9%=33/58).Conclusions The cervical length measured by ultra-sound is valuable in predicting preterm birth among the pregnancy women with threatened preterm birth .The transperineal ultrasonogra-phy is superior to transabdominal and transvaginal ultrasonography in predicting preterm birth , and is worth being popularized .