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目的 探讨经阴道超声测量宫颈长度对预测初产妇足月引产及分娩方式的价值。 方法 对 12 1例需引产的足月单胎初产孕妇 ,于引产当日经阴道超声测量宫颈长度、宫颈管的宽度 ,记录宫颈内口有无开大和宫颈的位置 ,同时由专人用指检法进行 Bishop评分 ,记录引产潜伏期 ,产程及分娩方式 ,分析引产潜伏期和分娩方式的相关因素。 结果 多因素逐步回归分析和对数回归显示单一超声测量的宫颈长度是预测引产潜伏期 (r=0 .6 7,P<0 .0 0 1)和分娩方式 (r=0 .6 1,P<0 .0 0 1)的相关因素 ,Bishop评分虽和宫颈长度相关 (r=- 0 .6 8,P<0 .0 0 1) ,但和宫颈长度相比不是预测引产潜伏期和分娩方式的相关因素。超声测量的宫颈长度 <3cm时 ,平均引产潜伏期 (9± 7) h,剖宫产率 34.5 % ;宫颈长度≥ 3cm时引产潜伏期 (2 3± 7) h,剖宫产率 88.1%。二者比较差异有显著性 (P<0 .0 0 1)。 结论 对于初产妇而言 ,经阴道超声测量宫颈长度可以预测引产潜伏期和分娩方式 ,优于传统的 Bishop评分。经阴道测量宫颈长度可以用于评价初产妇引产前的宫颈成熟度。
Objective To investigate the value of transvaginal ultrasonography in measuring the length of the cervix in predicting full-term labor induction and delivery of primipara. Methods A total of 121 full-term single-term pregnant women who needed induction of labor were enrolled. The length of the cervix and the width of the cervical canal were measured by vaginal ultrasound on the day of induced labor. The location of the cervix and the cervix was recorded. Bishop scoring, recording induction of labor latency, labor and delivery mode, analysis of induction of labor latency and delivery factors related factors. Results The multivariate stepwise regression analysis and logarithmic regression showed that the cervical length measured by single ultrasound was predictive of induction of labor (r = 0.67, P <0.001) and mode of delivery (r = 0.61, P < (P <0.01), although the Bishop score correlated with the length of the cervix (r = - 0.68, P <0.001), it was not correlated with predicting the latent period of labor induction and mode of delivery factor. When the length of cervix measured by ultrasound was less than 3 cm, the average latent period of induction of labor was (9 ± 7) h, the rate of cesarean section was 34.5%. The latent period of induction of labor was (23 ± 7) h when the length of the cervix was 3 cm and the rate of cesarean section was 88.1%. The difference was significant (P <0. 001). Conclusions For primiparous women, transvaginal ultrasonography of cervical length can predict the induction of labor and the mode of delivery, outperforming the traditional Bishop score. Transvaginal cervical length measurement can be used to evaluate preterm labor of primiparous cervical maturity.