Abstract：
OBJECTIVE: The aim of this study was to investigate guidelines on preterm birth, analyze decision-criteria, and to identify consensus and discrepancies among these guidelines.
METHODS: Objective consensus analysis of guidelines.
METHODS: Ten international guidelines on preterm birth.
METHODS: Relevant decision criteria were singleton vs. twin pregnancy, history, cervical length, and cervical surgery / trauma or Mullerian anomaly. Eight treatment recommendations were extracted. For each decision-making criteria the most commonly recommended treatment was identified, and the level of consensus was evaluated.
METHODS: Consensus and Discrepancies among recommendations.
RESULTS: In a case of singleton pregnancies with no history of preterm birth and shortened cervix, most guidelines recommend progesterone. In singleton pregnancies with a positive history and shortened cervix, all guidelines recommend a cerclage as an option, alternative or conjunct to progesterone. The majority of the guidelines advise against treatment in twin pregnancies.
CONCLUSIONS: A shortened cervix and a history of preterm birth are relevant in singleton pregnancies. In twins, most guidelines recommend no active treatment. Among international guidelines a shortened cervix and a history of preterm birth are relevant in singleton pregnancies. With no history of preterm birth and with a shortened cervix most guidelines recommend progesterone treatment.
METHODS: Objective consensus analysis of guidelines.
METHODS: Ten international guidelines on preterm birth.
METHODS: Relevant decision criteria were singleton vs. twin pregnancy, history, cervical length, and cervical surgery / trauma or Mullerian anomaly. Eight treatment recommendations were extracted. For each decision-making criteria the most commonly recommended treatment was identified, and the level of consensus was evaluated.
METHODS: Consensus and Discrepancies among recommendations.
RESULTS: In a case of singleton pregnancies with no history of preterm birth and shortened cervix, most guidelines recommend progesterone. In singleton pregnancies with a positive history and shortened cervix, all guidelines recommend a cerclage as an option, alternative or conjunct to progesterone. The majority of the guidelines advise against treatment in twin pregnancies.
CONCLUSIONS: A shortened cervix and a history of preterm birth are relevant in singleton pregnancies. In twins, most guidelines recommend no active treatment. Among international guidelines a shortened cervix and a history of preterm birth are relevant in singleton pregnancies. With no history of preterm birth and with a shortened cervix most guidelines recommend progesterone treatment.
摘要：
目的：本研究的目的是调查早产指南，分析决策标准，并确定这些准则之间的共识和差异。
方法：指南的客观共识分析。
方法：关于早产的十项国际指南。
方法：相关决策标准为单例与双胎妊娠,历史,宫颈长度,和颈椎手术/外伤或穆勒异常。提取了8个治疗建议。对于每个决策标准，确定了最常用的推荐治疗方法，并评估了共识水平。
方法：建议之间的共识和差异。
结果：在没有早产和子宫颈缩短的单胎妊娠病例中，大多数指南推荐黄体酮。在有阳性病史和子宫颈缩短的单胎妊娠中，所有指南都建议环扎作为一种选择，替代或联合黄体酮。大多数指南建议不要在双胎妊娠中进行治疗。
结论：子宫颈缩短和早产史与单胎妊娠有关。在双胞胎中，大多数指南建议不积极治疗。在国际指南中，子宫颈缩短和早产史与单胎妊娠有关。没有早产史，子宫颈缩短，大多数指南建议孕激素治疗。
方法：指南的客观共识分析。
方法：关于早产的十项国际指南。
方法：相关决策标准为单例与双胎妊娠,历史,宫颈长度,和颈椎手术/外伤或穆勒异常。提取了8个治疗建议。对于每个决策标准，确定了最常用的推荐治疗方法，并评估了共识水平。
方法：建议之间的共识和差异。
结果：在没有早产和子宫颈缩短的单胎妊娠病例中，大多数指南推荐黄体酮。在有阳性病史和子宫颈缩短的单胎妊娠中，所有指南都建议环扎作为一种选择，替代或联合黄体酮。大多数指南建议不要在双胎妊娠中进行治疗。
结论：子宫颈缩短和早产史与单胎妊娠有关。在双胞胎中，大多数指南建议不积极治疗。在国际指南中，子宫颈缩短和早产史与单胎妊娠有关。没有早产史，子宫颈缩短，大多数指南建议孕激素治疗。
