活跃期经会阴三维超声测量产程进展参数对分娩方式及分娩时长的预测价值研究  

Value of the intrapartum progression parameters measured by transperineal three-dimensional ultrasound at the active stage of labor in predicting delivery mode and time to delivery

作　　者：尤海英 罗漫灵[1] 尹爱兰[1] 王雪飞[1] 郭晓燕 钟梅[1] YOU Hai-ying;LUO Man-ling;YIN Ai-lan;WANG Xue-fei;GUO Xiao-yan;ZHONG Mei(Department of Obstetrics and Gynecology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院妇产科,广东广州510515 [2]清远市妇幼保健院,广东清远511500

出　　处：《中国实用妇科与产科杂志》2025年第1期110-114,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：广东省卫生适宜技术推广项目(202303231836281529)。

摘　　要：目的探讨活跃期经会阴三维超声测量产程进展参数对分娩方式及分娩时长的预测价值。方法选取2022年1月至2023年6月在清远市妇幼保健院阴道试产的184例单胎初产妇作为研究对象,在宫口开大6cm时经会阴三维超声测量以下参数:胎头进展角(AOP)、胎头进展距离(PD)、胎头方向角(HD),绘制受试者工作特征(ROC)曲线对比AOP、PD、HD对分娩方式的预测效能;以AOP、PD、HD的截断值进行分组,比较两组间自然分娩率及分娩时长的差异。结果最终有181例产妇被纳入分析:AOP、PD、HD预测自然分娩ROC曲线下面积分别为0.793、0.783、0.764(P<0.001),三者之间比较差异无统计学意义(P>0.05),AOP、PD、HD的最佳截断值分别为118.5°、30.5mm、87.5°。分别以AOP、PD、HD的最佳截断值118.5°、30.5mm、87.5°进行分组,AOP、PD、HD较大者,自然分娩率更高,分娩时长更短,差异均有统计学意义(P<0.01)。结论活跃期经会阴三维超声测量产程进展参数对分娩方式及分娩时长均有良好的预测价值,可辅助临床医生进行产程管理。Objective To evaluate the value of transperineal three-dimensional(3D)ultrasound measurements of intrapartum progression parameters during the active phase of labor for predicting the mode of delivery and the time to delivery.MethodsTotally 184 singleton nulliparous women from January 2022 to June 2023 were prospectively recruited in Maternal and Child health Hospital of Qingyuan City.Transperineal 3D ultrasound was utilized to measure the following parameters upon confirmation of cervical dilatation of 6 cm:angle of progression(AOP),progression distance(PD)and head direction(HD).Receiver operating characteristic(ROC)curves were drawn to assess the predictive accuracy of AOP,PD and HD for spontaneous vaginal delivery.Subjects were categorized based on the optimal cutoff points for each parameter,and intergroup comparisons were made regarding the rates of spontaneous delivery and the time to delivery.ResultsData from 181 participants were ultimately analyzed:(1)The areas under the ROC curves for spontaneous delivery prediction were 0.793 for AOP,0.783 for PD,and 0.764 for HD(P<0.001),without statistically significant differences among the parameters(P>0.05).The optimal cutoff points were determined as 118.5°for AOP,30.5 mm for PD,and 87.5°for HD(.2)The women were grouped based on the optimal cutoff points of AOP(118.5°),PD(30.5mm)and HD(87.5°),and the women with higher values for AOP,PD,and HD demonstrated significantly higher rates of spontaneous delivery and shorter time to delivery(P<0.01).ConclusionTransperineal 3D ultrasound measurement of labor progress parameters during the active phase of labor provides valuable predictive information regarding the mode of delivery and the time to delivery,which may aid clinicians in the management of labor.

关 键 词：经会阴超声 产程进展 产程监测 自然分娩 分娩时长 

分 类 号：R714[医药卫生—妇产科学]