臨床婦人科産科77巻4号

2023年04月発行

増刊号 ―豊富な所見で診断の進め方がわかる―産婦人科 画像診断アトラス

周産期 画像診断の進め方：胎児付属物の評価

子宮頸管長

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.62 - P.67

文献概要

●頸管長計測の際には膀胱を空虚にしておく．

●経腟プローブを押しつけず，pressureテストを行い，動的な評価も行う．

●画面の半分以上を占めるよう頸部を拡大し，組織学的内子宮口から外子宮口までの長さを測定する．

●sludgeやfunnelingの存在にも注意する．

参考文献

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

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

3）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

4）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

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

6）Owen J, et al : Mid-trimester endovaginal sonography in women at high risk for spontaneous preterm birth. JAMA 286 : 1340-1348, 2001

7）Li Q, et al : Precocious cervical ripening as a screening target to predict spontaneous preterm delivery among asymptomatic singleton pregnancies : a systematic review. Am J Obstet Gynecol 212 : 145-156, 2015

8）Shiozaki A, et al : Multiple pregnancy, short cervix, part-time worker, steroid use, low educational level and male fetus are risk factors for preterm birth in Japan : a multicenter, prospective study. J Obstet Gynaecol Res 40 : 53-61, 2014

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

10）Committee on Practice Bulletins-Obstetrics, et al : Practice bulletin no. 130 : prediction and prevention of preterm birth. Obstet Gynecol 120 : 964-973, 2012

11）Friedman AM, et al : Can transabdominal ultrasound be used as a screening test for short cervical length? Am J Obstet Gynecol 208 : 190.e1-190.e7, 2013

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

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