经腹部联合会阴超声测量产程进展参数在分娩时长预测中的价值研究

Value of Abdominal Perineal Ultrasonography in the Measurement of Labor Progress Parameters in the Prediction of Delivery Duration

目的探究经腹部联合会阴超声测量产程进展参数在分娩时长预测中的价值。方法研究对象为深圳市福田区妇幼保健院2016年2月—2018年2月收治的2000例足月、单胎、头先露、阴道试产初产妇,分别于宫口扩张4cm(T1)及T1后1~2h(T2)应用经腹部联合会阴超声测量脑中线角度(MLA)、胎头方向角(HD)、胎头下降距离(HPD)、胎头进展角(AOP),探究经腹部联合会阴超声测量产程进展参数在分娩时长预测中的价值。结果T2产程进展参数中HD2≤120°者与HD2>120°者自然分娩率差异无统计学意义(P>0.05);MLA2>75°者(79.92%)与MLA2≤75°者(98.17%),AOP2≤120°者(78.99%)与AOP2>120°者(96.19%),HPD2≤40mm者(85.37%)与HPD2>40mm者(98.01%),后者较前者自然分娩率均更高,差异有统计学意义(P<0.05)。结论将经腹部联合会阴超声检测应用于产妇产程检测时,能明确判断产妇的产程进展情况,此方法值得应用与推广。

Objective To explore the value of transabdominal combined perineal ultrasound in measuring the parameters of labor progress in predicting the length of delivery.Methods The subjects were 2 000 full-term,single,head-exposed and vaginal primipara admitted to the hospital from February,2016 to February,2018.The midbrain angle(MLA),fetal head direction angle(HD),fetal head progression distance(HPD)and fetal angle of pregression(AOP)were measured by transabdominal transvaginal ultrasound at 4cm(T1)and 1~2h(T2)after T1 respectively.The value of abdominal perineal ultrasound in measuring the parameters of labor progress in predicting the length of delivery was explored.Results There was no significant difference in spontaneous delivery rate between HD 2≤120° or HD2 >120° in T2 labor progression parameters(P>0.05).Those with MLA 2>75°(79.92%)and MLA 2≤75°(98.17%),those with AOP 2≤120°(78.99%)and AOP 2>120°(96.19%),those with HPD 2≤40 mm(85.37%)and HPD 2>40 mm(98.01%)had higher natural delivery rate than the former(P<0.05).Conclusion When transabdominal federation negative ultrasonography is applied to the detection of the parturient,the progress of the parturient can be clearly judged.This method is worthy of application and promotion.