孕晚期盆底超声检查参数对分娩方式的指导价值初探

Study on the guiding value of late pregnancy pelvic floor ultrasound parameters for delivery mode

目的探讨孕晚期盆底超声检查预测分娩方式的应用价值。方法符合观察条件的孕晚期初产妇262例,均接受盆底超声检查,随访分娩结局,统计分析盆底超声检查相关参数和分娩结局的相关性。结果分娩方式的ROC分析结果显示:最大瓦氏动作膀胱颈位置(P=0.016)和静息肛提肌裂孔面积(P=0.045)具有诊断价值。不同指标联合诊断中,灵敏度最高为静息肛提肌裂孔面积+Bishop评分并联诊断,特异度最高为最大瓦氏动作膀胱颈位置+Bishop评分串联诊断,约登指数最大为静息肛提肌裂孔面积+Bishop评分串联诊断。结论孕晚期最大瓦氏动作膀胱颈位置和静息肛提肌裂孔面积两个参数对分娩方式具有预测价值,孕晚期静息状态肛提肌裂孔面积和Bishop评分串联模式预测分娩方式的临床价值更高。

Objective To explore the application value of pelvic floor ultrasound in late pregnancy to predict the mode of delivery.Methods 262 cases of primipara in late pregnancy who met the study conditions were examined by pelvic floor ultrasound,follow-up of the outcome of the delivery,and statistical analysis of the correlation between parameters related to pelvic floor ultrasound and the outcome of delivery.Results The results of ROC analysis of delivery methods showed that the maximum valsalva bladder neck position(P=0.016)and the area of resting levator anatomy(P=0.045)had diagnostic value.In the combined diagnosis of different indicators,the highest sensitivity was the parallel apical muscle crepe area+Bishop score parallel diagnosis,the highest specificity was the maximum valsalva bladder neck position+Bishop score serial diagnosis,the Yoden index was the maximum resting levator muscle area+Bishop Score in tandem diagnosis.Conclusion The two parameters of maximum valsalva bladder neck position and resting levator muscle area in late pregnancy have predictive value for the mode of delivery.The clinical value of the levator ani muscle area and the Bishop score series predictive delivery mode are higher in late pregnancy.