三维能量多普勒超声评估宫颈以预测过期妊娠中使用前列腺素引产成功与否。

Three-dimensional power Doppler ultrasound assessment of the cervix for the prediction of successful induction of labor with prostaglandin in prolonged pregnancy.

作者信息

Rovas Linas, Sladkevicius Povilas, Strobel Eva, Valentin Lil

机构信息

Department of Obstetrics and Gynecology, Malmö University, Malmö, Sweden.

出版信息

J Ultrasound Med. 2005 Jul;24(7):933-9. doi: 10.7863/jum.2005.24.7.933.

DOI:10.7863/jum.2005.24.7.933

PMID:15972707

Abstract

OBJECTIVE

The purpose of this study was to determine whether 3-dimensional (3D) power Doppler ultrasound examination of the cervix can predict the success of labor induction with prostaglandin in prolonged pregnancy.

METHODS

A prospective study was conducted with 36 women undergoing labor induction with prostaglandin at 41 gestational weeks 5 days and later. All 36 women underwent a transvaginal 2-dimensional gray scale ultrasound examination and a 3D power Doppler ultrasound examination of the cervix immediately before a planned post-term checkup. The analyzed variables were length, anterior-posterior diameter, and width of the cervix and any cervical funneling, cervical volume (in cubic centimeters), vascularization index, flow index, vascularization flow index, parity, and Bishop score. Results were compared among women with start of labor at 12 hours or less and more than 12 hours after application of the first prostaglandin suppository and among women who had delivery at 24 hours or less and more than 24 hours after the start of induction.

RESULTS

Sonographically measured cervical length was shorter (mean, 1.8 versus 2.4 cm; P = .04), the Bishop score was higher (median, 5 versus 3; P = .02), and more women were parous (70% versus 37%; P = .05) among women who were in labor within 12 hours than in those who were not. The Bishop score was higher (median, 4 versus 2; P = .03) and more women were parous (69% versus 23%; P = .01) among women who had delivery at 24 hours or less than among those who did not. Cervical volume and the results of the 3D power Doppler ultrasound examination did not differ among women with different outcomes of labor induction.

CONCLUSIONS

In women undergoing induction of labor with prostaglandin at 41 gestational weeks 5 days or later, sonographic cervical length, Bishop score, and parity are related to the success of labor induction, whereas cervical volume and the results of the 3D power Doppler examination are not.

摘要

目的

本研究旨在确定对宫颈进行三维（3D）能量多普勒超声检查能否预测过期妊娠使用前列腺素引产的成功率。

方法

对36例妊娠41周5天及以后使用前列腺素引产的妇女进行了一项前瞻性研究。所有36例妇女在计划的过期检查前立即接受经阴道二维灰阶超声检查和宫颈三维能量多普勒超声检查。分析的变量包括宫颈的长度、前后径、宽度以及任何宫颈漏斗形成情况、宫颈体积（立方厘米）、血管化指数、血流指数、血管化血流指数、产次和Bishop评分。比较首次使用前列腺素栓后12小时内开始分娩的妇女与12小时后开始分娩的妇女，以及引产开始后24小时内分娩的妇女与24小时后分娩的妇女之间的结果。

结果

超声测量宫颈长度较短（平均1.8对2.4 cm；P = 0.04），Bishop评分较高（中位数5对3；P = 0.02），且首次使用前列腺素栓后12小时内分娩的妇女中经产妇更多（70%对37%；P = 0.05）。引产开始后24小时内分娩的妇女的Bishop评分较高（中位数4对2；P = 0.03），经产妇也更多（69%对23%；P = 0.01）。不同引产结局的妇女之间宫颈体积和三维能量多普勒超声检查结果无差异。