Jacobson J D, Gregerson G N, Dale P S, Valenzuela G J
Department of Gynecology and Obstetrics, School of Medicine, Loma Linda University, California.
Obstet Gynecol. 1990 Nov;76(5 Pt 1):755-8. doi: 10.1097/00006250-199011000-00005.
In an attempt to develop a reproducible, objective measure of adequate uterine activity in labor, real-time measurements of intrauterine pressure amplitude and contraction frequency, interval, duration, and integral were made in 54 patients, 11 of whom received oxytocin augmentation. We determined the active pressure integral required per centimeter of cervical dilatation, expressed in kPa seconds, and the mean active pressure, expressed in kPa. The augmented group had a significantly higher mean active pressure integral per centimeter than those in normal labor (P less than .01). There was a trend, which did not reach statistical significance, for subjects who required oxytocin augmentation of labor to develop a higher mean active pressure than those in normal labor. However, the correlation of any uterine contractility index (Montevideo units, Alexandria units, mean active pressure) with progress in labor was poor. We conclude that women with dysfunctional labor require more uterine activity for progress in labor than women with normally progressing labor, and that the computer-derived "area under the curve" is not a better predictor of labor progress than Montevideo units.
为了开发一种可重复、客观地衡量分娩时子宫活动是否充分的方法，对54例患者进行了子宫内压力幅度、宫缩频率、间隔、持续时间和积分的实时测量，其中11例接受了催产素加强宫缩治疗。我们确定了每厘米宫颈扩张所需的有效压力积分（以kPa秒表示）以及平均有效压力（以kPa表示）。加强宫缩组每厘米的平均有效压力积分明显高于正常分娩组（P<0.01）。需要催产素加强宫缩的产妇有出现比正常分娩产妇更高平均有效压力的趋势，但未达到统计学意义。然而，任何子宫收缩力指标（蒙得维的亚单位、亚历山大单位、平均有效压力）与分娩进展的相关性都很差。我们得出结论，与正常分娩进展的女性相比，分娩功能障碍的女性在分娩进展中需要更多的子宫活动，并且计算机得出的“曲线下面积”并不比分娩力单位（蒙得维的亚单位）更能预测分娩进展。
