摘要
目的:探讨超声测量产程进展角(AOP)和胎头-会阴距离(HPD)预测第二产程时长的可行性。方法:选择2022年9月至2024年6月在山东第一医科大学附属省立医院经阴道分娩的135例足月单胎初产妇,产程中均施行药物分娩镇痛,且在宫口开全时超声检查确定胎位为枕前位,于宫缩间期测量AOP和HPD。将所有产妇分为A组(第二产程时长≤60 min)、B组(60 min<第二产程时长≤120 min)和C组(第二产程时长>120 min),对比组间AOP和HPD的差异性,同时评估其对60 min和120 min内阴道分娩的预测效能。结果:(1)A组AOP明显高于B组,HPD明显低于B组,差异均有统计学意义(P<0.01)。B组AOP明显高于C组,HPD明显低于C组,差异均有统计学意义(P<0.05)。(2)AOP和HPD预测60min内阴道分娩的受试者工作特征(ROC)曲线下面积分别为0.872和0.914,最佳截断值分别为126.25°和4.52 cm(P<0.01)。(3)AOP和HPD预测120 min内阴道分娩的ROC曲线下面积分别为0.901和0.801,最佳截断值分别为116.40°和4.69 cm(P<0.01)。结论:临床上应用产时超声测量AOP与HPD预测第二产程时长是可行的。
Objective:To explore the feasibility of measuring the angle of progress(AOP)and the fetal head-perineum distance(HPD)by ultrasound to predict the duration of the second stage of labor.Methods:A total of 135 full-term singleton primiparas who gave birth through vagina in Shandong Provincial Hospital Affiliated to Shandong First Medical University from September 2022 to June 2024 were selected.They all received medication for labor analgesia during labor,and the fetal position was determined as occipital anterior position by ultrasound when the cervix was fully dilated.AOP and HPD were measured during the contraction interval.All parturients were divided into group A(duration of the second stage of labor≤60 min),group B(60 min<duration of the second stage of labor≤120 min)and group C(duration of the second stage of labor>120 min).The differences of AOP and HPD among these groups were compared,and their predictive efficacy for vaginal delivery within 60min and 120min was evaluated.Results:①The AOP in group A was higher than that in group B.The HPD in group A was lower than that in group B.The differences were statistically significant(P<0.01).The AOP in group B was higher than that in group C.The HPD in group B was lower than that in group C.The differences were statistically significant(P<0.05).②The area under the ROC curve for AOP and HPD to predict a vaginal delivery within 60 min was 0.872 and 0.914,and the optimal cut-off value was 126.25°and 4.52 cm,respectively(P<0.01).③The area under the ROC curve for AOP and HPD to predict a vaginal delivery within 120 min was 0.901 and 0.801,and the optimal cut-off value was 116.40°and 4.69 cm,respectively(P<0.01).Conclusions:It is feasible to predict the duration of the second stage of labor duration by measuring AOP and HPD using intrapartum ultrasound.
作者
刘霄
张媛媛
卢媛
曹南南
王谢桐
LIU Xiao;ZHANG Yuanyuan;LU Yuan(Department of Obstetrical,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan Shandong 250021,China)
出处
《实用妇产科杂志》
北大核心
2025年第6期496-500,共5页
Journal of Practical Obstetrics and Gynecology
基金
国家高端外国专家引进计划项目(编号:G2023023009)。
关键词
产时超声
产程进展角
胎头-会阴距离
第二产程
时长
Intrapartum ultrasound
Angle of progression
Head-perineum distance
The second stage of labor
Duration
作者简介
通讯作者:王谢桐,E-mail:wxt65@vip.163.com。
