会阴超声探测宫颈形态学指标对足月初产妇临产时间及分娩方式的预测研究

Research on the prediction of parturient time and delivery mode of fullterm primipara by morphological indicators of perineal ultrasound detection of cervix

目的:评价会阴超声探测宫颈形态对预测足月初产妇临产时间及分娩方式的效果。方法:应用会阴超声探测和妇科指检法对127例初产妇宫颈形态学变化进行Bishop评分,观察羊膜囊嵌入宫内口扩张的最大前后径、内口扩张深度、剩余宫颈的长度、宽度及头位胎儿胎产势等指标对其宫颈成熟度进行评分,与产妇临产时间及分娩方式相结合进行分析。结果:会阴超声检查方法简单直观,对产妇的刺激小,较少引起孕妇不适感,便于操作;产妇宫颈长度、内口开大程度等指标是临产时间的影响因素(P<0.05);超声评分≥-4.5的孕妇易在12 h内临产(P<0.001);预测结果与观察实际结果一致性很好。结论:对于初产妇,会阴超声探测宫颈形态可以预测临产时间和分娩方式,优于传统的Bishop评分。对临产时间及分娩方式有一定提示作用,是一种客观准确的方法,适合在各级医院推广。

Objective： To evaluate the prediction of parturient time and delivery mode of full-term primipara by morphological indicators of perineal ultrasound detection of cervix.Methods： Use perineum ultrasonography and gynecological finger examination method to conduct Bishop marking on primipara cervix morphological variation of 127 cases,including marking on maximum anteroposterior diameter and depth of uterus internal ostium expansion after insertion of amniotic sac,length and width of remaining cervix and tire production type of fetal head position,to evaluate the maturity of cervix and to analyze the combination of parturient parturient time and delivery mode.Results： Perineum ultrasonography examination methods was simple and intuitional.The incitement on parturients was minor and there was rarely any discomfort caused to pregnant women.It was easy to operate too.Indexes such as parturient cervix length and internal ostium expansion were the influential factors of Parturient time（P〈0.05）;pregnant women with ultrasonographic markings of ≥-4.5 were likely to be parturient within 12 hours（P〈0.001）.The consistency between prediction results and observation actual results was good.Conclusion： Perineal ultrasound detection can help predict parturient time and delivery mode for primipara.It is better than traditional Bishop marking.It has certain prompting effects on parturient time and delivery mode.As an objective and accurate method it is suitable for popularization in hospitals at all levels.