产前超声动态测量在初产妇分娩方式预测中的诊断价值

Predictive value of prenatal ultrasound dynamic measurement for primipara delivery

目的分析产前超声动态测量对初产妇分娩方式的预测价值。方法选取2017年1月至2018年1月在衢州市中医医院行产检并生产的203例孕妇作为研究对象,根据其生产方式将其分为阴道分娩组(n=151)及剖宫产组(n=52),比较两组孕妇年龄、BMI等基线资料,并比较两组孕妇产前超声动态监测相关指标,分析相关影响因素对预测初产妇生产方式的诊断价值。结果两组孕妇年龄、BMI等基线资料及第一产程潜伏期的HD、HPD、AOP比较,差异均无统计学意义(均P>0.05);阴道分娩组产妇活跃期的HD、HPD、AOP及活跃期与潜伏期比值均明显高于剖宫产组,差异均具有统计学意义(均P<0.05);Logistic回归分析显示,活跃期的HPD、AOP及HD、HPD、AOP活跃期与潜伏期比值均是阴道分娩的保护因素(均P<0.05);ROC曲线显示,HD、HPD、AOP活跃期与潜伏期比值联合诊断在预测孕妇分娩方式方面具有较高的诊断效能(AUC=0.873),明显高于HPD、AOP及HD、HPD、AOP活跃期与潜伏期比值的单一诊断,差异均具有统计学意义(均P<0.05)。结论产前超声动态测量第一产程活跃期的HD、HPD及AOP活跃期与潜伏期比值联合诊断,对预测孕妇分娩方式具有较高的诊断价值及诊断效能,可用于预测产妇的分娩方式。

Objective To analyze the predictive value of prenatal ultrasound dynamic measurement for primipara delivery.Methods A total of 203 pregnant women who underwent antenatal examination and gave birth in Quzhou Municipal Hospital of TCM from January 2017 to January 2018 were selected,and divided into vaginal delivery group(n=151)and cesarean section group(n=52)according to their modes of delivery.The general data such as age and BMI of pregnant women in the two groups were compared,and the relevant indicators of prenatal ultrasound dynamic monitoring were compared between the two groups to analyze the diagnostic value of relevant influ-encing factors in predicting the mode of delivery of primiparas.Results There were no significant differences in the age,BMI,and HD,HPD,and AOP values between the two groups(all P>0.05).The vaginal delivery group had HD,HPD,AOP and active maternal periods.The ratio of active period to latent period was significantly higher than that of cesarean section(all P<0.05).Logistic analysis showed that active period HPD,AOP and HD,HPD,AOP active/latency ratio were protective factors for vaginal delivery(all P<0.05);ROC curve shows that HD,HPD and AOP active period,latency ratio combined diagnosis has a higher diagnostic efficiency(AUC=0.873),which is significantly higher than HPD,AOP and HD,HPD,AOP active period.Single diagnosis of latency/latency ratio(all P<0.05).Conclusions Prenatal ultrasound dynamic measurement of the first stage of labor of HD,HPD in active period and AOP active/latency ratio combined diagnosis in the prediction of pregnant women delivery mode has a higher diagnostic value and efficacy,can be used to predict maternal delivery.