Bahadori Fatemeh, Ayatollahi Hale, Naghavi-Behzad Mohammad, Khalkhali Hamidreza, Naseri Zilla
Department of Obstetrics & Gynecology, Urmia University of Medical Sciences, Urmia, Iran.
Med Ultrason. 2013 Sep;15(3):191-8. doi: 10.11152/mu.2013.2066.153.fb1ha2.
Induction of labor is conducted in special fetal or maternal conditions. Labor is induced in about 20% of women. The AIM of this study was realizing the relationship between some factors including cervical ripening and also response to induction so we could predict the induction outcome better.
The present prospective study was based on 101 pregnancy cases admitted to the labor ward in Urmia from March 2010 until December 2010. Maternal age ranged from 17 to 41 years and the gestational age between 37 to 42 weeks according to an ultrasound or reliable last menstrual period, as criteria of study inclusion. After admission, patients had a vaginal speculum for Preterm Premature Rupture of Membranes (PPROM), Abdominal ultrasonography for biometry and Amniotic Fluid Index (AFI), transperineal ultrasonography for measuring fetal head distance to maternal perineum, and vaginal ultrasonography for measuring cervical length and posterior angle of fetal head with cervix were undergone. Bishop score was assigned to another person. Labor was induced by administering either intravaginal misoprostol (25 microgram every six hours for a Bishop score lower than 7) or intravenous oxytocin (low dose regimen for a Bishop score equal to or more than 7).
Misoprostol was used for 75 patients and 26 patients had induction of labor with low dose oxytocin. Eighty one patients had Normal Vaginal Delivery (NVD) while 20 were delivered via Cesarean Section. For cervical ripening, Bishop Score (p<0.001), cervical length (p=0.04) and parity (p=0.06) were predicting factors. The cervical posterior angle p=0.02 had a predicting role in natural delivery.
The cervical posterior angle was a predicting factor for natural delivery. Although cervical length, Body Mass Index (BMI), and parity were not predicting factors for natural delivery; these factors were good predictors for cervical ripening.
引产在特殊的胎儿或母体情况下进行。约20%的女性会接受引产。本研究的目的是了解包括宫颈成熟度在内的一些因素与引产反应之间的关系，以便我们能更好地预测引产结果。
本前瞻性研究基于2010年3月至2010年12月在乌尔米耶市产科病房收治的101例妊娠病例。根据超声检查或可靠的末次月经日期，纳入研究的标准为产妇年龄在17至41岁之间，孕周在37至42周之间。入院后，患者接受了用于检查胎膜早破（PPROM）的阴道窥器检查、用于生物测量和羊水指数（AFI）的腹部超声检查、用于测量胎儿头部到产妇会阴距离的经会阴超声检查，以及用于测量宫颈长度和胎儿头部与宫颈后角的阴道超声检查。Bishop评分由另一人进行评估。引产采用阴道内给予米索前列醇（Bishop评分低于7分时每6小时25微克）或静脉注射缩宫素（Bishop评分等于或高于7分时采用低剂量方案）。
75例患者使用了米索前列醇，26例患者采用低剂量缩宫素引产。81例患者顺产，20例通过剖宫产分娩。对于宫颈成熟度，Bishop评分（p<0.001）、宫颈长度（p=0.04）和产次（p=0.06）是预测因素。宫颈后角（p=0.02）在自然分娩中具有预测作用。
宫颈后角是自然分娩的预测因素。虽然宫颈长度、体重指数（BMI）和产次不是自然分娩的预测因素；但这些因素是宫颈成熟度的良好预测指标。
