论文部分内容阅读
目的探讨经会阴三维超声测量产程进展参数在分娩时长预测中的价值。方法纳入2015年9-12月在南方医科大学南方医院妇产科足月、单胎、头先露、阴道试产初产妇共151例。分别于宫口扩张4 cm(T1)及T1后1~2 h(T2)应用经会阴三维超声测量产程进展参数:胎头方向角(HD)、脑中线角度(MLA)、胎头下降距离(HPD)、胎头进展角(AOP)。应用卡方检验对T1、T2各产程进展参数分组的自然分娩率进行对比性研究。应用Kaplan-Meier法分析T1、T2产程进展参数对孕妇分娩时长的预测价值。结果 (1)AOP≤110°者(82.4%)与AOP>110°者(96.0%),后者较前者自然分娩率更高,差异有统计学意义(P<0.05);MLA>75°者(82.1%)与MLA≤75°者(97.7%),HPD≤40mm者(85.3%)与HPD>40 mm者(98.5%),AOP≤120°者(81.0%)与AOP>120°者(96.0%),后者较前者自然分娩率均更高,差异有统计学意义(P<0.05)。(2)T1时,以90°、75°、30 mm、110°分别作为HD、MLA、HPD、AOP的截断值,HD、HPD、AOP较大者,MLA较小者更快分娩,差异均有统计学意义(P<0.05);T2时,以120°、75°、40 mm、120°分别作为HD、MLA、HPD、AOP的截断值,HD、HPD、AOP较大者,MLA较小者更快分娩,差异均有统计学意义(P<0.05)。结论经会阴三维超声测量产程进展参数对分娩时长有良好的预测价值。
Objective To investigate the value of measuring the progress of labor during three-dimensional perineal ultrasound in predicting labor duration. Methods Ninety-one cases of primipara between January 9 and December 2015 in Nanfang Hospital of Southern Medical University were included in this study. The progress of labor was measured by perineal three-dimensional ultrasonography at 4 cm (T1) of cervix and 1 ~ 2 h (T1) of T1 respectively. The parameters including birth angle (HD), midline angle (MLA) HPD), fetal head progress angle (AOP). The chi-square test was used to compare the natural delivery rates of progress parameters grouping in T1 and T2. Kaplan-Meier method was used to analyze the predictive value of the progress parameters of T1 and T2 labor on the delivery duration of pregnant women. Results (1) AOP≤110 ° (82.4%) and AOP> 110 ° (96.0%), the latter than the former natural delivery rate was higher, the difference was statistically significant (P <0.05); MLA> 75 ° (82.1%) with MLA≤75 ° (97.7%), HPD≤40 mm (85.3%) and HPD> 40 mm (98.5%) with AOP≤120 ° (81.0%) and AOP> 120 ° 96.0%), the latter than the former natural delivery rate was higher, the difference was statistically significant (P <0.05). (2) At T1, the cutoff values of HD, MLA, HPD and AOP were 90 °, 75 °, 30 mm and 110 °, respectively, and those with HD, HPD, AOP and MLA had faster delivery (P <0.05). At T2, the cutoff values of HD, MLA, HPD and AOP were 120 °, 75 °, 40 mm and 120 °, respectively. Who delivered faster, the differences were statistically significant (P <0.05). Conclusion The three-dimensional ultrasound of perineal measurement of labor progress parameters have a good predictive value of labor duration.