Aran Turhan, Osmanagaoglu Mehmet A, Kart Cavit, Guven Suleyman, Sahin Mustafa, Unsal Mesut A
Departments of Obstetrics and Gynecology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Int Urogynecol J. 2012 Aug;23(8):1105-10. doi: 10.1007/s00192-012-1754-7. Epub 2012 Apr 14.
The prolongation, protraction or complete cessation of labor is called failed labor. It is one of the leading indications for cesarean delivery. The goal of this study was to measure pelvic floor muscle strength and investigate its effect on labor in nulliparous pregnant women.
A total of 88 patients were included in the study. The study was conducted in nulliparous pregnant women with a low Bishop score (≤ 7). A low-dose intravenous oxytocin protocol was used for labor induction in all patients. Evaluation of pelvic floor muscle (PFM) strength was performed using a vaginal pressure measurement device just before labor induction. The duration of labor stages and the rate of failed labor were considered the main outcomes. The study group consisted of patients whose labor failed and who subsequently underwent cesarean delivery. The control group consisted of patients who delivered vaginally. The pelvic floor muscle strength and main outcome measures of the two groups were compared.
No differences were found in age, weight, height, body mass index (BMI), and neonatal birth weight between the study and control groups. The mean resting and maximum squeeze pressures in the study group were 29.6 ± 9.8 and 56.4 ± 12.1 cm H(2)O respectively, significantly higher than in the control group. The best predictor of failed labor was a maximum squeeze pressure value of 59 cm H(2)0 (51.6% sensitivity and 87.7% specificity).
Pelvic floor muscle strength appears to play a role in predicting failed labor.
产程延长、进展缓慢或完全停滞被称为产程异常。这是剖宫产的主要指征之一。本研究的目的是测量初产妇的盆底肌肉力量，并研究其对分娩的影响。
本研究共纳入88例患者。研究对象为Bishop评分较低（≤7分）的初产妇。所有患者均采用低剂量静脉滴注缩宫素方案引产。在引产即将开始前，使用阴道压力测量装置评估盆底肌肉（PFM）力量。产程各阶段的持续时间和产程异常发生率被视为主要结局指标。研究组由产程异常并随后接受剖宫产的患者组成。对照组由经阴道分娩的患者组成。比较两组的盆底肌肉力量和主要结局指标。
研究组与对照组在年龄、体重、身高、体重指数（BMI）和新生儿出生体重方面均未发现差异。研究组的平均静息压力和最大收缩压力分别为29.6±9.8 cm H₂O和56.4±12.1 cm H₂O，显著高于对照组。产程异常的最佳预测指标是最大收缩压力值为59 cm H₂O（敏感性为51.6%，特异性为87.7%）。
盆底肌肉力量似乎在预测产程异常中发挥作用。
