产时B超监测在阴道试产孕妇产程中的应用价值  

Application value of intrapartum B-ultrasound monitoring in the labor process of pregnant women with vaginal trial labor

作　　者：王卫平[1] 杨俊娟[2] 赵蒙[1] Wang Weiping;Yang Junjuan;Zhao Meng(Department of Ultrasonic Diagnosis,Zhengzhou Maternal and Child Health Hospital,Zhengzhou 450000,China;Department of Obstetrics,Zhengzhou Maternal and Child Health Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市妇幼保健院超声诊断科,郑州450000 [2]郑州市妇幼保健院产科,郑州450000

出　　处：《中国实用医刊》2022年第23期68-71,共4页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20210786)。

摘　　要：目的分析产时B超监测在阴道试产孕妇产程中的应用价值。方法抽取2021年6月至2022年6月郑州市妇幼保健院收治的阴道试产孕妇200例。采用阴道检查对孕妇宫口、胎方位、胎先露进行监测,采用产时B超对宫口、胎方位、胎先露、产程进展角(AOP)、胎头至会阴距离(HPD)进行测量,统计产时B超和阴道检查数据的差异性,分析产时B超监测对产程的预测作用。结果200例孕妇中,阴道检查与B超监测的宫口差距占比较高的依次为:0~<0.5 cm者53例(26.50%),≥1.0 cm者52例(26.00%),0.5~<1.0 cm者38例(19.00%);阴道检查与B超监测的胎先露差距占比较高的依次为:>1 cm者70例(35.00%),0 cm 48例(24.00%),1 cm 43例(21.50%);阴道检查与B超监测的胎方位差距:胎方位相同141例(70.50%),胎方位不同24例(12.00%),仅B超可监测16例(8.00%),胎方位相似15例(7.50%),仅阴道检查可监测4例(2.00%)。第一产程活跃期时,AOP≤122.5°时的自然分娩率为50.00%(10/20),低于AOP>122.5°时的95.83%(23/24),P<0.05;HPD≥41.5 mm时的自然分娩率为43.75%(7/16),低于HPD<41.5 mm时的92.86%(26/28),P<0.05。结论产时B超监测在阴道试产孕妇产程中可监测宫口、胎方位、胎先露等产程数据,准确判断产程进展情况,有利于预测分娩结局。Objective To analyze the application value of intrapartum B-ultrasound monitoring in the labor process of pregnant women with vaginal trial labor.Methods A total of 200 pregnant women with vaginal trial delivery in Zhengzhou Maternal and Child Health Hospital from June 2021 to June 2022 were selected.The vaginal examination was used to monitor the maternal cervix,fetal position,and fetal presentation,and intrapartum B-ultrasound was used to measure the maternal cervix,fetal position,fetal presentation,angle of progression(AOP),and head-perineum distance(HPD).The differences between intrapartum B-ultrasound and vaginal examination data were analyzed,and the predictive effect of intrapartum B-ultrasound monitoring on the labor process was analyzed.Results Among the 200 pregnant women,the sequence of proportion of difference in maternal cervix detected by vaginal examination and by ultrasound monitoring from high to low were as follows:53 cases(26.50%)with 0 to<0.5 cm,52 cases(26.00%)with less or equal to 1.0 cm,and 38 cases(19.00%)with 0.5 cm to 1.0 cm.The difference in fetal presentation detected by vaginal examination and by B-ultrasound monitoring were as follows:70 cases(35.00%)with>1 cm,48 cases(24.00%)with 0 cm,and 43 cases(21.50%)with 1 cm.The difference in fetal orientation monitored by vaginal examination and by B ultrasound were as follows:141 cases(70.50%)with the same fetal orientation,24 cases(12.00%)with different fetal orientations,16 cases(8.00%)detected only by B ultrasound,15 cases(7.50%)with similar fetal orientations,and 4 cases(2.00%)monitored only by vaginal examination.At the active stage of the first stage of labor,the natural delivery rate was 50.00%(10/20)when AOP≤122.5°,which was lower than 95.83%(23/24)when AOP>122.5°,P<0.05.The natural delivery rate was 43.75%(7/16)when HPD≥41.5 mm,which was lower than 92.86%(26/28)when HPD<41.5 mm(P<0.05).Conclusions Intrapartum B-ultrasound monitoring can monitor labor data such as the maternal cervix,fetal position,and fetal presentation during

关 键 词：产程 孕妇 阴道试产 产时B超监测 

分 类 号：R714.3[医药卫生—妇产科学]