目的前瞻性研究足月妊娠引产前采用超声弹性成像评估宫颈成熟度的临床价值。方法单胎、头位、足月妊娠的147例孕妇在宫颈后穹隆放置地诺前列酮栓促宫颈成熟前,超声弹性测量子宫颈矢状面上硬度比(hardness ratio)、宫颈内口应变平均值(in...目的前瞻性研究足月妊娠引产前采用超声弹性成像评估宫颈成熟度的临床价值。方法单胎、头位、足月妊娠的147例孕妇在宫颈后穹隆放置地诺前列酮栓促宫颈成熟前,超声弹性测量子宫颈矢状面上硬度比(hardness ratio)、宫颈内口应变平均值(internal cervical os,IOS)、宫颈外口应变平均值(external cervical os,EOS)、IOS/EOS比值(Ratio)及宫颈长度数值。分析宫颈弹性测量数值、内诊Bishop评分与引产成功率的关系。结果引产成功105例,成功率71.42%,其中顺产96例,剖宫产9例;促宫颈成熟后未临产42例,其中置药24小时未临产,取药后拒绝继续引产直接剖宫产30例,取药后加用缩宫素引产失败12例。临产组和未临产组年龄、孕周、分娩前体质指数均无差异,引产前二组手法Bishop评分差异无统计学意义。对比两组内的彩超弹性测量数值发现:临产组孕妇的宫颈内口和外口的弹性具有一致性,无统计学差异(0.3108±0.093 vs 0.3031±0.108,t=0.659,P=0.511>0.05),未临产孕妇的宫颈内口较外口硬(0.368±0.112 vs 0.326±0.091,t=2.57,P=0.015<0.05,差异有显著性)。两组之间比较宫颈弹性测量数值发现:未临产组孕妇宫颈内口(IOS)较临产者硬(0.368±0.112 vs 0.311±0.093,t=2.810,P=0.009<0.05),而两组EOS无统计学差异。结论手法Bishop评分法结合超声宫颈弹性成像,对预测促宫颈成熟起到了规范化、标准化的作用,能预测引产成功率。宫颈弹性测量是手法Bishop评分法的客观补充指标。展开更多
Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the presen...Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the present study is to highlight the prevalence of physical coercion leading to pregnancy and the associated maternal-fetal complications. Methodology: This was a comparative descriptive and analytical cross-sectional study of complications associated with post-rape pregnancy by physical restraint among minors who were treated at the General Reference Hospital of Panzi over a two-year period from June 2020 to June 2022. A total of 140 minor survivors of violence with pregnancy were included in the study. Data were collected using a questionnaire, coded and analyzed in Excel and XLSTAT version 2014. Results: The prevalence of physical constraints was 65%. After mulltivariate analyses, denial of pregnancy (ORa: 9.64 95% CI: 1.1 - 81.2;p-value: 0.0370), attempted abortion (ORa: 56.1 95% CI: 1.5 - 2027.6;p-value: 0.0278) and agitation during delivery (ORa: 88.7 95% CI: 4.5 - 1715;p-value: 0.0030) were the complications associated with pregnancy in minors who experienced physical restraint rape. In addition, BMI was a factor in reducing the risk of physical restraint rape at the ORa of 0.5054 [0.3;0.8];p 0.006). Conclusion: Pregnancy among minors is a reality and occurs in a situation of physical coercion in the eastern Democratic Republic of Congo. These pregnancies are often associated with complications that require an intensive management system since they can jeopardize the maternal-fetal prognosis of minors.展开更多
文摘目的前瞻性研究足月妊娠引产前采用超声弹性成像评估宫颈成熟度的临床价值。方法单胎、头位、足月妊娠的147例孕妇在宫颈后穹隆放置地诺前列酮栓促宫颈成熟前,超声弹性测量子宫颈矢状面上硬度比(hardness ratio)、宫颈内口应变平均值(internal cervical os,IOS)、宫颈外口应变平均值(external cervical os,EOS)、IOS/EOS比值(Ratio)及宫颈长度数值。分析宫颈弹性测量数值、内诊Bishop评分与引产成功率的关系。结果引产成功105例,成功率71.42%,其中顺产96例,剖宫产9例;促宫颈成熟后未临产42例,其中置药24小时未临产,取药后拒绝继续引产直接剖宫产30例,取药后加用缩宫素引产失败12例。临产组和未临产组年龄、孕周、分娩前体质指数均无差异,引产前二组手法Bishop评分差异无统计学意义。对比两组内的彩超弹性测量数值发现:临产组孕妇的宫颈内口和外口的弹性具有一致性,无统计学差异(0.3108±0.093 vs 0.3031±0.108,t=0.659,P=0.511>0.05),未临产孕妇的宫颈内口较外口硬(0.368±0.112 vs 0.326±0.091,t=2.57,P=0.015<0.05,差异有显著性)。两组之间比较宫颈弹性测量数值发现:未临产组孕妇宫颈内口(IOS)较临产者硬(0.368±0.112 vs 0.311±0.093,t=2.810,P=0.009<0.05),而两组EOS无统计学差异。结论手法Bishop评分法结合超声宫颈弹性成像,对预测促宫颈成熟起到了规范化、标准化的作用,能预测引产成功率。宫颈弹性测量是手法Bishop评分法的客观补充指标。
文摘Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the present study is to highlight the prevalence of physical coercion leading to pregnancy and the associated maternal-fetal complications. Methodology: This was a comparative descriptive and analytical cross-sectional study of complications associated with post-rape pregnancy by physical restraint among minors who were treated at the General Reference Hospital of Panzi over a two-year period from June 2020 to June 2022. A total of 140 minor survivors of violence with pregnancy were included in the study. Data were collected using a questionnaire, coded and analyzed in Excel and XLSTAT version 2014. Results: The prevalence of physical constraints was 65%. After mulltivariate analyses, denial of pregnancy (ORa: 9.64 95% CI: 1.1 - 81.2;p-value: 0.0370), attempted abortion (ORa: 56.1 95% CI: 1.5 - 2027.6;p-value: 0.0278) and agitation during delivery (ORa: 88.7 95% CI: 4.5 - 1715;p-value: 0.0030) were the complications associated with pregnancy in minors who experienced physical restraint rape. In addition, BMI was a factor in reducing the risk of physical restraint rape at the ORa of 0.5054 [0.3;0.8];p 0.006). Conclusion: Pregnancy among minors is a reality and occurs in a situation of physical coercion in the eastern Democratic Republic of Congo. These pregnancies are often associated with complications that require an intensive management system since they can jeopardize the maternal-fetal prognosis of minors.
