会阴超声在孕晚期宫颈条件评估及临产时间预测中的应用价值

The significance of transperineal sonographic examination for assessment of cervical condition and prediction of labor time in third trimester pregnancy

目的:探讨会阴超声对于孕晚期宫颈条件的评估以及临床时间的预测价值。方法:选取168例接受超声检查的孕晚期孕妇,分别采用经腹部超声、经阴道超声以及经会阴超声检查宫颈参数,分析宫颈形态与临产时间之间的关系。结果:经会阴超声对宫颈的显示率为100.00%,显著高于经腹超声的90.48%,且差异有统计学意义(x^2=8.006,P<0.05),而与经阴道超声的100.00%无差异;会阴超声与经阴道超声测得宫颈管长度相比,无明显差异(t=1.219,t=0.852;P>0.05),而经腹超声测得的宫颈管长度显著低于经阴道及经会阴超声(t=17.156/19.435,t=19.560/19.039;P<0.05);宫颈长度与临产时间呈显著正相关性(r=0.721,P<0.05),宫颈内口宽度、胎先露高度及羊膜囊嵌入宫颈管深度与临产时间呈显著负相关性(t=35.559,t=33.613,t=38.362;P<0.05),而宫颈宽度与临产时间无显著相关性(r=-0.182,P>0.05)。结论:会阴超声检查在孕晚期宫颈条件评估中具有与经阴道超声较好的一致性,且宫颈参数对于临产时间的预测具有重要价值,对于产时决策具有重要指导意义,值得推广应用。

Objective： To evaluate the significance of transperineal sonographic examination for assessment of cervical condition and prediction of labor time in third trimester pregnancy. Methods： One hundred and sixty eight cases were collected, all received abdominal ultrasound, transvaginal ultrasound and cervical transperineal ultrasound parameters, the relationship between cervical morphology and labor time was analyzed. Results： The display rate of cervical by transperineal sonographic examination was 100.00%, significantly higher than 90.48% by transabdominal ultrasound（x^2=8.006, P0.05）, but was no difference with 100.00% by transvaginal ultrasound; the cervical length measured by transperineal sonographic and transvaginal ultrasound was significant difference（t=1.219, t=0.852; P0.05）, and abdominal ultrasound measured cervical length was significantly lower than the transperineal sonographic and transvaginal ultrasound（t=17.156/19.435, t=19.560/19.039; P0.05）; Cervical length showed significant positive correlation with labor time（r=0.721, P0.05）; cervix width, fetal height and amniotic sac embedded cervical depth showed significant negative correlation with labor time（t=35.559, t=33.613, t=38.362; P0.05）, and cervical width labor was no significant correlation with labor time（r=-0.182, P0.05）. Conclusion： Transperineal sonographic examination has a better consistency with transvaginal ultrasound for assessment of Cervical condition in third trimester pregnancy, and Cervical parameters is valuable for prediction of labor time, it has important significance for decision of childbirth, should be widely applied.