产程评估中经会阴超声头部推进距离与数字检查Bishop评分的相关性研究

A. el-habashy
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摘要

目的:应用经会阴超声(TPUS)评价头部进展距离(PD)在评估产程中的作用。材料与方法:本研究对El-Shatby妇产大学医院收治的60例产程活跃期、足月单胎妊娠经顶点表现的产妇进行分析。我们测量了每个病例入院时,1小时后和2小时后的头部进展距离(PD)(使用经会阴超声),并通过数字检查将其与Bishop评分相关联。我们还记录了所有情况下的交货方式。结果:平均头进展距离(PD)与入院时、1小时后和2小时后的胎头位置有统计学意义。HPD会随着产程和胎儿头部下降而延长。入院时Bishop评分预测分娩方式的敏感性为58.33%(截止7),1小时后预测分娩方式的敏感性为75%(截止9),2小时后预测分娩方式的敏感性为91.67%(截止10)。入院时头部进展距离(PD)预测分娩方式的敏感性为66.67%,截止时间为44mm, 1小时后为75%,截止时间为51mm, 2小时后为91.67%,截止时间为63mm。结论:产时经会阴超声(tpu)测量头部进展距离(PD)与数字检查Bishop评分相关。随着分娩的进展,PD的增加与阴道分娩的可能性增加有关。PD可用于客观评价产程。
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Correlation Between the Head Progression Distance Using Intrapartum Transperineal Ultrasound and the Bishop Score Using Digital Examination in Assessment of Labor Progress
Aim: Evaluation of the role of head progression distance (PD) using the transperineal ultrasound (TPUS) in assessment of progress of labor. Materials and Methods: This study conducted on 60 cases admitted to El-Shatby Maternity University Hospital in active phase of labor, at full term with singleton pregnancy presented by vertex. We measured the head progression distance (PD) in each case on admission, after 1 hour and after 2 hours (using transperineal ultrasound) and correlated it with the Bishop score by digital examination. We documented also the mode of delivery in all cases. Results: The mean head progression distance (PD) had a statistically significant association with the fetal head station on admission, after 1 hour and after 2 hours. HPD will get longer with the progress of labor with the fetal head descent. The sensitivity of Bishop score on admission to predict the mode of delivery was 58.33% at cut-off 7, after 1 hour it was 75% at cut-off 9 and after 2 hours it was 91.67% at cut-off 10. The sensitivity of head progression distance (PD) on admission to predict the mode of delivery was 66.67% at cut-off 44mm, after 1 hour it was 75% at cut-off 51mm and after 2 hours it was 91.67% at cut-off 63mm. Conclusion: Head progression distance (PD) measurement using intrapartum transperineal ultrasound (TPUS) is correlated with Bishop score using digital examination. The increasing PD with progress of labor is associated with more likelihood of vaginal delivery. PD can be used for objective assessment of progress of labor.
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