摘要
目的探讨第一产程超声测量指标对阴道分娩及分娩时长的预测价值。方法选取2021年5月至2023年5月足月单胎初产妇120例,于宫口开大2~3 cm时采用经会阴超声测量产程进展角(AOP)、胎头会阴距离(HPD)、大脑中线角(MLA)。追踪产妇分娩结局,根据是否阴道分娩分为阴道分娩组(107例)和剖宫产组(13例),分析AOP、HPD、MLA对阴道分娩的预测效能。以AOP、HPD、MLA最佳截断值分组,比较不同亚组分娩时长的差异。结果阴道分娩组和剖宫产组产妇AOP、HPD、MLA的差异有统计学意义(P<0.05)。AOP、HPD、MLA预测阴道分娩的曲线下面积分别为0.903、0.818、0.663,最佳截断值分别为119°、4 cm、72°。AO P<119°组和AOP≥119°组中位分娩时长为82 min和72 min,差异有统计学意义(χ^(2)=7.441,P=0.006);HPD<4cm组和HPD≥4cm组中位分娩时长为74 min和82 min,差异有统计学意义(χ^(2)=6.670,P=0.010);MLA<72°组和MLA≥72°组中位分娩时长为79 min和82 min,差异无统计学意义(χ^(2)=1.040,P=0.308)。结论第一产程超声测量AOP、HPD对单胎初产妇阴道分娩及分娩时长有良好的预测价值。
Objective To explore prediction value of transperineal ultrasound(TPUS)at the first stage of labor in predicting the delivery mode and time to delivery in primiparous women with a singleton pregnancy.Methods A total of 120 primiparous women with a singleton pregnancy from May 2021 to May 2023 were selected.The angle of progression(AOP),head perineum distance(HPD)and midline angle(MLA)were measured by TPUS after cervix enlargement of 2-3cm.Delivery outcomes were recorded.According to whether there was a spontaneous vaginal delivery,primiparous women were divided into the vaginal delivery group(n=107)and cesarean section group(n=13).The effectiveness of AOP,HPD and MLA in predicting vaginal delivery was analyzed.Then the women were grouped by the cut-off values of AOP,HPD and MLA,and the vaginal delivery rate and time to delivery between groups were compared.Results There were significant differences in the AOP,HPD,and MLA between the two groups(P<0.05).The area under the curve(AUC)of AOP,HPD and MLA to predict a vaginal delivery was 0.903,0.818 and 0.663,respectively,with the optimal cut-off of 119°,4cm and 72°,respectively.The median time to delivery in the AO P<119°group and AOP≥119°group was 82min and 72min,respectively,showing a significant difference(χ^(2)=7.441,P=0.006).The median time to delivery in the HPD<4cm group and HPD≥4cm group was 74min and 82min,respectively,showing a significant difference(χ^(2)=6.670,P=0.010).The median time to delivery in the MLA<72°group and MLA≥72°group was 79min and 82min,respectively,and with no statistically significant difference(χ^(2)=1.040,P=0.308).Conclusion AOP and HPD detection in the first stage of labor have good values in predicting vaginal delivery and time to delivery.
作者
李平华
周玲
段淑坡
崔小娟
李建敏
任伟
LI Pinghua;ZHOU Ling;DUAN Shupo(Department of Obstetrics,Xingtai General Hospital,North China Medical and Health Group,Hebei,Xingtai 054000,China;不详)
出处
《河北医药》
2025年第4期607-610,共4页
Hebei Medical Journal
基金
河北省医学科学研究课题计划(编号:20191184)。
关键词
超声
第一产程
分娩方式
分娩时长
ultrasound
first stage of labor
mode of delivery
time to delivery
作者简介
通信作者:周玲,E-mail:zhouling007@126.com。
