摘要
目的:探究第一产程经会阴二、三维超声检测指标对初产妇阴道分娩及分娩时长的预测价值。方法:回顾性分析2022年1月至2024年1月在暨南大学附属顺德医院首次分娩的单胎孕妇共119例。于宫颈口扩张3~4 cm时行经会阴二维超声测量产程进展角(AOP)、会阴与胎头距离(HPD),三维超声测量耻骨弓角度(PAA)。根据初产妇是否阴道分娩分为阴道分娩组(85例)和非阴道分娩组(34例),比较两组一般临床资料及超声参数指标;采用多因素Logistic回归分析AOP、HPD及PAA与初产妇阴道分娩的关系。绘制受试者工作特征曲线评估参数对阴道分娩的预测价值。根据AOP、HPD及PAA的中位数进行分组,比较各组分娩时长的差异。结果:与非阴道分娩组相比,阴道分娩组孕妇AOP、PAA水平较高,HPD水平较低(P<0.05)。多因素分析显示AOP、HPD及PAA均为阴道分娩独立影响因素(P<0.05),三者联合预测阴道分娩的曲线下面积分别为0.896(P<0.05)。AOP>136°、HPD≤4 cm、PAA>99°组孕妇分娩时长较短(P<0.05)。结论:第一产程经会阴二、三维超声检测指标AOP、HPD及PAA对初产妇阴道分娩及分娩时长具有较高的预测价值,可协助分娩管理。
Objective:To explore the predictive value of perineal two‑dimensional and three‑dimensional ultrasound indicators during the first stage of labor on vaginal delivery and duration of labor in primiparous women.Methods:A retrospective analysis was conducted on 119 singleton pregnant women who delivered for the first time at Shunde Hospital of Jinan University from January 2022 to January 2024.Two‑dimensional ultrasound was used to measure the angle of progression(AOP)and the distance between the perineum and fetal head(HPD)when the cervical dilation was 3-4 cm,and three‑dimensional ultrasound was used to measure the pubic arch angle(PAA).The women were divided into a vaginal delivery group(85 cases)and a non‑vaginal delivery group(34 cases)based on the mode of delivery,and general clinical data and ultrasound parameters were compared between the two groups.Multivariate logistic regression analysis was used to analyze the relationship between AOP,HPD,and PAA and vaginal delivery in primiparous women.Receiver operating characteristic curves were drawn to evaluate the predictive value of the parameters for vaginal delivery.The groups were divided based on the median values(M)of AOP,HPD,and PAA to compare the differences in the duration of labor.Results:Compared to the non‑vaginal delivery group,the vaginal delivery group showed higher levels of AOP and PAA,and lower levels of HPD(P<0.05).Multifactorial analysis indicated that AOP,HPD,and PAA are independent factors influencing vaginal delivery(P<0.05),and together,these factors predict vaginal delivery with an area under the curve of 0.896(P<0.05).Additionally,women with AOP greater than 136°,HPD less than or equal to 4 cm,and PAA greater than 99°had shorter durations of labor(P<0.05).Conclusion:Perineal two‑dimensional and three‑dimensional ultrasound indicators AOP,HPD,and PAA have high predictive value for vaginal delivery and the duration of labor in primiparous women,which can assist in labor management.
作者
陈捷
黄国伟
黄秋英
CHEN Jie;HUANG Guowei;HUANG Qiuying(Obstetrics and Gynecology,Shunde Hospital Affiliated to Jinan University,Foshan 528305,Guangdong,China)
出处
《广州医科大学学报》
2024年第5期30-34,共5页
Academic Journal of Guangzhou Medical University
关键词
会阴超声
第一产程
阴道分娩
分娩时长
预测价值
perineal ultrasound
first labor progress
delivery time
predictive value
