应用会阴B超检测宫颈成熟度预测前列腺素E_2引产效果的价值  

Cervical Ripening Score by Transperineal Ultrasonography and its Predictive Effect for Induction of Labor by Prostaglandin E 2

作　　者：李青[1,2,3] 张建平[1,2,3] 游志颖 

机构地区：[1]中山医科大学孙逸仙纪念医院妇产科 [2]中山医科大学妇幼卫生系 [3]中山医科大学卫生统计学教研室

出　　处：《中华妇产科杂志》1998年第4期216-218,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的评价会阴Ｂ超检测宫颈成熟度对预测前列腺素Ｅ２凝胶引产效果的价值。方法用会阴Ｂ超和指检法检测１０５例初产妇宫颈的成熟状况，记录引产潜伏期（引产至临产的时间），并进行Ｃｏｘ模型多因素分析。结果会阴Ｂ超检查简单直观，较少引起孕妇不适感；宫颈长度、内口开大程度和先露高低是引产潜伏期的影响因素（Ｐ＜０．０５）；Ｂ超评分≥－４５的孕妇易在１２小时内临产（Ｐ＜０．００１）；预测结果与观察实际结果一致性很好，误诊较少（Ｋａｐｐａ值、特异性和阳性预测值依次为０．７４０９、０．７９１７、０．９２５４），均优于Ｂｉｓｈｏｐ评分（相应结果为０．５６８０、０．６６６７、０８８０６）。结论会阴Ｂ超安全有效，其宫颈成熟度评分预测前列腺素Ｅ２凝胶引产难易程度效果较好。Objective To establish a cervical ripening score by transperineal ultrasonography for induction of labor by Prostaglandin E 2, and evaluate its predictive effect Methods 105 primiparae underwent cervical assessment by digital and transperineal ultrasonography examination. The five indices of cervical status, other clinical parameters and latency period (from induction to the onset of labor) were analysed by Cox multivariate model.Results Transperineal ultransonography was simple, visualable satisfactorily, noninvasive and less uncomfortable The width of cervical internal os,the length of the canal and position of the presenting part were the main factors that influenced the latency period ( P <0.05). Primiparae with score ≥-4.5 were easy to initiate the onset of labor within 12 hours ( P <0.001). The predictive results were in good agreement with clinical outcomes, and had less misdiagnosis (the Kappa value, specificity and the positive predictive value were 0.740 9, 0.791 7 and 0.925 4, respectively), and were better than the Bishop score (the corresponding value were 0.568 0, 0.666 7 and 0.880 6, respectively).Conclusions Transperineal ultrasonography is safe and effective. In predicting the effect on induction of labor of prostaglandin E 2 in primiparae, the transperineal ultrasonographic cervical ripening score is a valuable method.

关 键 词：妊娠晚期 药物引产 子宫颈 诊断 B超 PGE2 

分 类 号：R719.31[医药卫生—妇产科学] R445.1[医药卫生—临床医学]