MRI测量产前骨盆倾斜度与阴道分娩结局的关系  

Relationship between prenatal pelvic inclination measured by MRI and vaginal delivery outcome

作　　者：张若仙 何玉琴 吴松鑫 唐雯 雷琼[2] 刘国成[2] 江魁明[1] ZHANG Ruo-xian;HE Yu-qin;WU Song-xin(Department of Radiology,Guangdong Women and Children Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院放射科,广州511400 [2]广东省妇幼保健院产科,广州511400

出　　处：《放射学实践》2022年第5期580-583,共4页Radiologic Practice

基　　金：广州市科技计划项目(201804010048)。

摘　　要：目的:采用MRI测量产前骨盆倾斜度,探讨其与阴道分娩结局的关系。方法:搜集2016年9月-2019年7月在我院住院的分娩产妇为研究对象。病例纳入标准:足月妊娠、单胎、头位、初产妇;有阴道试产的强烈愿望。病例排除标准:存在妊娠合并症或并发症、骨盆狭窄、脐带或胎盘异常、羊水异常、巨大儿、使用催产素或分娩镇痛、有MRI检查禁忌症(体内金属植入物、幽闭恐惧症)。获取患者知情同意后在产前一周内进行MRI骨盆测量。依据阴道试产结局及骨盆倾斜度大小将研究对象进行分组,分析骨盆倾斜度与阴道分娩结局的关系。结果:最终纳入161例产妇。自然分娩组与助产、试产失败中转剖宫产组的骨盆倾斜度差异无统计学意义(P>0.05);骨盆倾斜度<70°组与≥70°组在分娩方式、胎儿宫内窘迫及新生儿窒息发生率、产后出血量方面差异无统计学意义(P>0.05);骨盆倾斜度≥70°组相较于骨盆倾斜度<70°组的第一产程及总产程时长延长。结论:骨盆倾斜度过大可能导致产程延长,但最终对于阴道分娩结局没有显著影响,不足以成为预测分娩方式的因素之一。Objective:To explore the relationship between pelvic inclination measured by MRI and vaginal delivery outcome.Methods:The puerpera who delivered in our hospital from September 2016 to July 2019 were included.Inclusion criteria:full term pregnancy,singleton,head position,primipara;with a strong desire for vaginal delivery.Exclusion criteria:complications of pregnancy;pelvic stenosis;abnormal umbilical cord or placenta;abnormal amniotic fluid;macrosomia;history of using oxytocin or labor analgesia;MRI contraindications(i.e.,metal implants,claustrophobia).MRI pelvic measurements were performed within one week prior to delivery after obtaining informed consent.The subjects were grouped according to the outcome of vaginal trial or pelvic inclination,and the relationship between pelvic inclination and vaginal delivery outcome were analyzed.Results:161 cases were finally included.There were no significant differences in pelvic inclination between the natural delivery group and the midwifery or cesarean section after failed trial delivery(P>0.05).There was no significant difference in delivery mode,incidence of fetal distress and neonatal asphyxia,the amount of postpartum hemorrhage between pelvic inclination<70°and≥70°groups(P>0.05).The duration of the first stage of labor and the total stage of labor were prolonged in group pelvic inclination≥70°compared with those pelvic inclination<70°.Conclusions:Excessive pelvic tilt may lead to prolonged labor,but it has no significant effect on the outcome of vaginal delivery,indicating that pelvic inclination is not the predictive factor for the model of delivery.

关 键 词：骨盆倾斜度 分娩结局 自然分娩 磁共振成像 

分 类 号：R714.3[医药卫生—妇产科学] R445.2[医药卫生—临床医学]