摘要
目的研究腹部联合会阴超声判定胎方位、宫口大小、胎先露最低点位置在产程观察中的应用,探讨超声检查能否替代传统"阴道指检"来监测产程进展。方法招募2015年11月至2016年10月于东阿县人民医院行阴道试产的孕妇100例。产程中应用腹部联合会阴超声检查和阴道指检,对比二者判定胎方位的准确率;分析超声检查宫颈前后唇距离和阴道指检宫颈扩张的关系;分析超声检查的产程进展角度数与阴道指检评定的胎先露最低点位置的关系。结果二维超声检查和阴道指检的胎方位符合率分别为100.00%和74.76%,超声检查较优(χ~2=27.35,P<0.01)。超声检查与阴道指检评估宫颈扩张误差平均值为0.15±0.36cm(95%CI:0.09~0.21),绝对误差平均值为0.31±0.23cm(95%CI:0.27~0.35)。超声检查宫颈前后唇距离和阴道指检宫颈扩张呈线性关系,回归方程:Y阴道指检宫颈扩张值=1.03X-0.03(X:超声检查宫颈前后唇距离,R2=0.98,P<0.05)。超声测量的产程进展角度数与阴道指检检查评定的胎先露最低点位置也呈线性关系,回归方程:Y产程进展角度数=10.68X+100.78(X:胎先露最低点位置,R2=0.89,P<0.05)。结论经腹部联合会阴超声检查能替代阴道指检来监测产程进展。
Objective To study the clinical application of abdominal ultrasound examination combined with perineal ultrasound examination to determine position of fetus,size of cervix,and the lowest position of fetal presentation during labor observation and to explore whether the ultrasound examination can replace traditional vaginal finger examination to monitor the progress of labor.Methods A total of 100 pregnant women who underwent vaginal trial-delivery in Dong＇e People＇s Hospital during November 2015 and October 2016 were recruited.During the labor process,abdominal combined with perineal ultrasound examination and vaginal finger examination were adopted,and the accuracy of the two methods for determining the position of fetus was compared.The correlation between the distance of the anterior and posterior lip of the cervix estimated by ultrasound examination and cervical dilatation estimated by vaginal finger examination was analyzed,and the correlation between degree of angle in labor progress estimated by ultrasound examination and the lowest position of fetal presentation estimated by vaginal finger examination was also analyzed.Results The coincidence rate of fetal position measured by 2 D（2 dimension）ultrasound examination and vaginal finger examination was 100.00% and 74.76%,respectively.Therefore,the ultrasound examination was superior to vaginal finger examination（χ^2=27.35,P〈0.01）.The average value of error in estimating cervical dilatation by ultrasound examination and vaginal finger examination was 0.15±0.36 cm（95% CI：0.09-0.21）,and the average value of absolute error was 0.31±0.23 cm（95%CI：0.27-0.35）.There was a significant linear correlation between the distance of the anterior and posterior lip of the cervix estimated by ultrasound examination and cervical dilatation estimated by vaginal finger examination,and the linear regression equation was Y=1.03 X-0.03（R2=0.98,P〈0.05;X：the distance of the anterior and posterior lip of the cervix estimated by ultrasound examination
作者
姜燕
于健
赵亚敏
李秀英
马良坤
JIANG Yan;YU Jian;ZHAO Ya-min;LI Xiu-ying;MA Liang-kun(Dong＇e People＇s Hospital,Shandong Dong＇e 252201,China;Peking Union Medical College Hospital,Beijing 100730,China)
出处
《中国妇幼健康研究》
2018年第7期894-897,共4页
Chinese Journal of Woman and Child Health Research
关键词
超声检查
产程监测
胎方位
宫颈扩张
产程进展角
ultrasound examination
labor monitoring
position of the fetus
cervical dilatation
angle inlabor progress
