最近审阅: 23 十月 2020
最近更新: 01 六月 2017

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 宫缩
  • 未足月胎膜早破 (PPROM)
  • 宫颈进一步扩张
  • 宫颈长度<2 cm

其他诊断因素

  • 母体或胎儿心率增快
  • 非特异性的下腹疼痛或背痛
  • 发热
  • 阴道出血

危险因素

  • 既往早产史
  • 既往宫颈损伤史
  • 既往人工引产史
  • 母体感染
  • 多胎妊娠
  • 宫颈长度缩短
  • 胎儿纤连蛋白检测阳性
  • 未足月胎膜早破 (PPROM)
  • 胎儿异常
  • 吸烟
  • 体重指数 (BMI)<19 kg/m^2
  • 社会因素与种族差异
  • 羊水过多
  • 家庭暴力
  • 口腔卫生不良

诊断性检查

首要检查

  • 无应激的胎心监护图
  • 分娩力描记法
  • 经阴道超声宫颈长度测量
  • 宫颈阴道拭子检测胎儿纤连蛋白
  • 全血细胞计数
  • C反应蛋白
  • 尿液试纸
  • 尿液镜检、培养及药敏试验
  • 高位阴道/直肠拭子
更多 首要检查

需考虑的检查

  • 硝嗪试验
  • 阴道分泌液显微镜检
  • Kleihauer血液检测
  • 尿液毒理学筛查
  • IGFBP-1(胰岛素样生长因子结合蛋白-1)检测
更多 需考虑的检查

新兴检查

  • 胎盘α-1 微球蛋白 (placental alpha microglobulin-1, PAMG-1)
更多 新兴检查

治疗流程

撰稿人

Professor of Obstetrics

King's College London

London

UK

利益声明

AHS gives educational talks financially supported by Hologic and is UK chief investigator for a tocolysis trial sponsored by GlaxoSmithKline. AHS is an author of a number of references cited in this monograph.

Consultant in Obstetrics and Gynaecology

West Middlesex University Hospital

London

UK

利益声明

JCG declares that she has no competing interests.

同行评议者展开全部内容

Consultant Obstetrician and Gynaecologist

St Michael's Maternity Wing

Bristol Royal Infirmary

Bristol

UK

利益声明

JT is the primary author of one RCT cited in this monograph. This trial was funded by an NHS Research and Development Grant and a donation from Exelgyn, the manufacturer of misoprostol. JT has accepted honoraria for speaking to groups of midwives and doctors about miscarriage management.

Consultant Obstetrician and Gynaecologist

Royal Infirmary of Edinburgh

Honorary Senior Lecturer

University of Edinburgh

Edinburgh

UK

利益声明

KD declares that she has no competing interests.

Assistant Professor of Maternal-Fetal Medicine

Stanford University

Stanford

CA

利益声明

DL declares that she has no competing interests.

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