臨床婦人科産科71巻4号

2017年04月発行

増刊号 産婦人科画像診断トレーニング─この所見をどう読むか？ 周産期

症例：妊娠中期⓰

著者： 大槻克文¹

所属機関： ¹昭和大学江東豊洲病院周産期センター

ページ範囲：P.117 - P.123

この画像をどう読むか？

症例

患者　32歳，1経妊0経産，自然流産1回（30歳時，19週でp-PROM）．

既往歴　28歳でCIN 3にて円錐切除．

図1aは他院より緊急搬送当日，図1bは入院翌日の経腟超音波像である．

Q1　この画像から得られる所見は何か？

Q2　図1bの問題点（図1aとの違い）は何か？

解答，解説は次のぺージに☞

参考文献

1）Berghella V, et al : Cervical funneling : sonographic criteria predictive of preterm delivery. Ultrasound Obstet Gynecol 10 : 161─166, 1997

2）Romero R, et al : What is amniotic fluid ‘sludge’? Ultrasound Obstet Gynecol 30 : 793─798, 2007

3）Yost NP, et al : Second-trimester cervical sonography : features other than cervical length to predict spontaneous preterm birth. Obstet Gynecol 103 : 457─462, 2004

4）Burger M, et al : Measurement of the pregnant cervix by transvaginal sonography : an interobserver study and new standards to improve the interobserver variability. Ultrasound Obstet Gynecol 9 : 188─193, 1997

5）Berghella V : Universal cervical length screening for prediction and prevention of preterm birth. Obstet Gynecol Surv 67 : 653─658, 2012

6）Committee on Practice Bulletins-Obstetrics TACoO, Gynecologists. Practice bulletin no. 130 : prediction and prevention of preterm birth. Obstet Gynecol 120 : 964─973, 2012

7）Friedman AM, et al : Can transabdominal ultrasound be used as a screening test for short cervical length? Am J Obstet Gynecol 208 : 190. e1─7, 2013

8）Macdonald R, et al : Cervical incompetence : the use of transvaginal sonography to provide an objective diagnosis. Ultrasound Obstet Gynecol 18 : 211─216, 2001

9）Yost NP, et al : Pitfalls in ultrasonic cervical length measurement for predicting preterm birth. Obstet Gynecol 93 : 510─516, 1999

10）Berghella V, et al : Cervical ultrasonography compared with manual examination as a predictor of preterm delivery. Am J Obstet Gynecol 177 : 723─730, 1997

11）Okitsu O, et al : Early prediction of preterm delivery by transvaginal ultrasonography. Ultrasound Obstet Gynecol 2 : 402─409, 1992

12）Iams JD, et al : The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network. N Engl J Med 334 : 567─572, 1996

13）Guzman ER, et al : Cervical length and spontaneous prematurity : laying the foundation for future interventional randomized trials for the short cervix. Ultrasound Obstet Gynecol 18 : 195─199, 2001

14）Owen J, et al : Vaginal sonography and cervical incompetence. Am J Obstet Gynecol 188 : 586─596, 2003

15）Taipale P, et al : Sonographic measurement of uterine cervix at 18-22 weeks' gestation and the risk of preterm delivery. Obstet Gynecol 92 : 902─907, 1998

16）Guzman ER, et al : A comparison of sonographic cervical parameters in predicting spontaneous preterm birth in high-risk singleton gestations. Ultrasound Obstet Gynecol 18 : 204─210, 2001

17）深見武彦，他 : 妊娠中期の子宮頸部超音波画像による切迫流早産の前方視的検討．産婦の実際49 : 101─108, 2000