经会阴3D超声测量耻骨弓角度对阴道分娩的预测价值

The prognostic efficacy of measuring the pubic arch angle with three-dimensional transperineal ultrasound for vaginal delivery

目的:研究会阴测量耻骨弓角度(PAA)的分布特征及其对分娩方式、产程时长的预测价值。方法:收集2021年1月至12月在首都医科大学附属北京天坛医院住院分娩的301例孕妇的临床资料,使用3D超声经会阴测量PAA,采用回归研究分析其与分娩方式、产程时长的关系。结果:301例孕妇中,产前剖宫产组82例,产程剖宫产组49例,阴道分娩组170例(包括正常阴道分娩组155例和产钳组15例)。正常阴道分娩组和产钳组的PAA均大于产程剖宫产组(P=0.000和0.052)。PAA可显著正向预测正常阴道分娩(P=0.000),其曲线下面积为0.782(P=0.000,95%CI为0.717~0.848)。线性回归发现,PAA可正向预测第二产程时长(P=0.035)。结论:PAA可预测正常阴道分娩,并预测第二产程时长。

Objective:To examine the distribution characteristics of the pubic arch angle(PAA)and its predictive value for the mode of delivery and duration of labor.Methods:A total of 301 pregnant women who gave birth at Beijing Tiantan Hospital,Capital Medical University,between January and December 2021 were included in this study.The PAA was measured using 3D perineal ultrasound,and regression analysis was performed to evaluate its relationship with the mode of delivery and duration of labor.Results:Among the enrolled participants,82 underwent antepartum cesarean section,49 underwent intrapartum cesarean section,and 170 had vaginal deliveries(155 normal vaginal deliveries and 15 forceps deliveries).The PAA was greater in both the normal vaginal deliveries and forceps groups than in the labor cesarean group(P=0.000 and 0.052).The PAA significantly predicted normal vaginal delivery(P=0.000)with an area under the curve of 0.782(P=0.000,95%CI:0.717~0.848).Linear regression analysis revealed a positive association between PAA and the duration of the second stage of labor(P=0.035).Conclusion:The PAA can serve as a valuable predictor for normal vaginal delivery and the duration of the second stage of labor.