产程进展时间与AOP、HPD的相关性研究

Study on Correlation Between Labor Progression Time and AOP and HPD

目的探讨产程进展时间与胎头进展角(AOP)、胎头下降距离(HPD)的相关性。方法选取我院2021年2月至2022年12月期间接收的足月妊娠产妇117例作为研究对象,在宫口开全时均行超声检查。对比不同分娩方式产妇的AOP、HPD,分析AOP、HPD预测分娩方式效能。按照AOP、HPD中位数分组,对比组间经阴道分娩率、分娩时长,分析分娩时间与AOP、HPD相关性。结果经阴道分娩产妇HPD少于未阴道分娩产妇,AOP高于未阴道分娩产妇(P<0.05);AOP≤135°产妇分娩时间长于AOP>135°产妇,经阴道分娩率低于AOP>135°产妇(P<0.05);HPD≤4.0cm产妇分娩时间短于HPD>4.0cm产妇,经阴道分娩率高于HPD>4.0cm产妇(P<0.05);经Pearson分析,AOP与产程时间呈负相关,HPD与产程时间呈正相关(P<0.05);受试者工作特征(ROC)曲线显示,AOP、HPD联合预测足月妊娠产妇分娩方式的曲线下面积(AUC)为0.860,均高于单一指标(P<0.05);HPD、AOP高水平产妇发生未阴道分娩的危险度为低水平的2.242倍、0.628倍(P<0.05)。结论AOP、HPD可作为临床足月产妇分娩方式选择予以指导,并能辅助评估分娩时长,有利于增强母婴安全性。

Objective To investigate the correlation between labor progression time and angle of progression(AOP)and head progression distance(HPD).Methods A total of 117 full-term pregnant women admitted to our hospital from February 2021~December 2022 were selected as research objects.Ultrasound examination was performed at the whole time of uterine opening.To compare the AOP and HPD of different delivery mode,analyze the effectiveness of AOP and HPD in predicting delivery mode.According to the median of AOP and HPD,the vaginal delivery rate and delivery duration between groups were compared,and the correlation between delivery time and AOP and HPD was analyzed.Results The HPD and AOP of the parturients in vaginal delivery were lower than those without vaginal delivery(P<0.05).The labor time of women with AOP≤135°was longer than those with AOP>135°,and the vaginal delivery rate was lower than those with AOP>135°(P<0.05).The delivery time of HPD≤4.0cm women was shorter than that of HPD>4.0cm women,and the vaginal delivery rate was higher than that of HPD>4.0cm women(P<0.05).Pearson analysis showed that AOP was negatively correlated with labor time,while HPD was positively correlated with labor time(P<0.05).Receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of AOP and HPD combined to predict delivery mode of full-term pregnant women was 0.860,which was higher than that of single index(P<0.05).The risk of non-vaginal delivery was 2.242 times and 0.628 times higher than that of low level of HPD and AOP(P<0.05).Conclusion AOP and HPD can be used as guidance for the selection of delivery methods in clinical full-term parturients,and can assist in the evaluation of delivery duration,which is conducive to enhancing the safety of mother and child.