产时超声在产程监测中的应用  

Application of Intrapartum Ultrasound in Labor Monitoring

作　　者：孙璐鑫 韩英杰(审校)[2] SUN Lu-xin;HAN Ying-jie(School of Graduate Department,Shandong First Medical University&Shandong Academy of Medical Sciences,Jinan 250117,China;Department of Obstetrics,Jining First People′s Hospital,Jining 272100,Shandong Province,China)

机构地区：[1]山东第一医科大学(山东省医学科学院)研究生部,济南250117 [2]济宁市第一人民医院产科

出　　处：《国际生殖健康/计划生育杂志》2025年第1期84-88,共5页Journal of International Reproductive Health/Family Planning

摘　　要：分娩过程中,准确评估胎方位、胎先露位置和宫颈扩张程度对于判断产程进展和选择分娩方式至关重要。然而,传统的阴道触诊可能带来不良的分娩体验和感染风险。近年来,产时超声因具有高准确性、良好的可重复性和较高的孕产妇依从性,逐渐成为产程监测的重要工具。其通过测量宫颈扩张(cervical dilatation,CD)、产程进展角(angle of progression,AOP)、胎头与会阴间距离(head-perineum distance,HPD)、胎头耻骨联合间距离(head-symphysis distance,HSD)、中线角(midline angle,MLA)、胎头方向(head direction,HD)、胎头下降距离(progression distance,PD)、枕骨脊柱角(occiput-spine angle,OSA)和下颌胸骨角(chinchest angle,CCA)等关键参数,能够精确定位胎方位和胎头位置,有助于及时识别异常胎位,为是否需要借助吸引器或产钳来辅助分娩或者进行剖宫产提供了依据,从而改善分娩结局、降低并发症风险。尽管超声在产程监测中具有辅助作用,但其应用仍需更多临床数据支持以完善和提升。随着技术进步,产时超声有望更广泛地推广,提升分娩管理的专业性和安全性。Accurate assessment of fetal position,fetal presenting part,and cervical dilation during labor are critical for evaluating labor progression and determining the mode of delivery.However,traditional vaginal examination may lead to adverse birthing experiences and carry a risk of infection.In recent years,intrapartum ultrasound has emerged as an essential tool for labor monitoring due to its high accuracy,reproducibility,and better maternal compliance.By measuring the key parameters such as cervical dilatation(CD),angle of progression(AOP),head-perineum distance(HPD),head-symphysis distance(HSD),midline angle(MLA),head direction(HD),progression distance(PD),occiput-spine angle(OSA)and chin-chest angle(CCA),ultrasound enables precise determination of fetal position and fetal head location.Therefore,intrapartum ultrasound facilitates the timely identification of abnormal fetal positions and provides a guidance on whether interventions such as vacuum extraction,forceps-assisted delivery,or cesarean section are necessary,thereby improves delivery outcomes and reduces the risk of complications.Although ultrasound has demonstrated its auxiliary role in labor monitoring,further clinical data are needed so as to refine and enhance its application.With advancements in technology,intrapartum ultrasound is expected to become more widely adopted,and to enhance the professionalism and safety in labor management.

关 键 词：胎产式 试分娩 产程 第一 产程 第二 产程 第三 产时超声 分娩管理 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714[医药卫生—诊断学]