经会阴超声宫颈成熟度评分在产科的应用价值(1)
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【摘要】目的:通过经会阴超声宫颈成熟度评分对先兆早产保胎效果及足月头位分娩启动的研究，探讨其在产科的应用价值。方法:利用经会阴超声，对38例先兆早产孕妇及45例足月初产妇宫颈成熟度评分，测量宫颈管长度、内口扩张程度、HM等指标，并随访其妊娠结局。结果(1)38例先兆早产孕妇中，宫颈管平均长度为(26.49±2.77)mm，显著短于正常组的(35.89±2.77)mm(p<0.001); 随着宫颈管长度及HM分值的增加，早产发生率明显增高。(2)45例足月初产妇，随宫颈成熟度评分增加,临产时间愈缩短；宫颈成熟度评分0～ 4 分组(18 例)、5～ 8 分组(15 例)、≥9 分组(12 例) ，剖宫产率分别为66. 7% (12/18)、40% (6/15) 及16.7% (2/12) , 0～ 4 分组与≥9 分组相比剖宫产率差异有统计学意义(P < 0. 01)。结论 经会阴超声宫颈成熟度评分在产科中具有重要应用价值，能预测先兆早产保胎治疗效果；预计足月初产妇分娩启动、决定分娩方式,是一种客观、准确、简便、安全的评分方法。
【关键词】经会阴超声；宫颈成熟度评分；先兆早产保胎；足月头位分娩启动及方式
The Value of Transperineal Sonographic Measurement of Cervical Maturity
Yang Qing1 Xia Fei2 Hu Ting3
【Abstract】 Objective: To evaluate the value of transperineal sonographic measurement of cervical maturity for predicting effect of threatened preterm and set of head fetation in full-term primipara. Methods: Thirty eight threatened preterm and 45 full-term primipara were detected Cervical maturity，depth of uterus internal ostium expansion and HM by transperineal ultrasonography，and pregnancy outcome was interviewed as well. Results:(1)In 38 threatened preterm group，the mean cervical length was(26.49±2.77)mm，far shorter than normal ones 35.89±2.77 mm(P<0.001); with increasing cervical length and HM markings, incidence of threatened pregnancy was much larger.(2)In 45 full-term primipara group, with the increase of cervical maturity score，parturient time was far shorter；according to cervical maturity score 3 groups were divided as following：markings of 0～4 (n=18), markings of 5～8 (n=12)，markings of ≥9 (n=12)，and the caesarean rate was 66.7%(12/18)，40%(6/15)，16.7%(2/12)respectively. Conclusions: Markings of cervical maturity via transperineal sonographic measurement may be both of great value and as an objective, accurate, simple and safety method , and may predict the effect of therapy of threatened preterm and set of delivery mode for full-term primipara.
【Keywords】Transperineal sonography; Markings of cervical maturity;threatened preterm; delivery mode ;full-term primipara
【中图分类号】R352 【文献标识码】A 【文章编号】1005-0515(2011)07-0024-02
孕妇宫颈的观察是产科超声检查的重要部分,临床上常规采用的是Bishop式评分 ......
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