Comas Montse, Cochs Belén, Martí Laia, Ruiz Raquel, Maireles Sònia, Costa Jordi, Canet Yolanda
a Department of Obstetrics and Gynecology , Corporació Sanitària Parc Taulí , Universitat Autònoma de Barcelona , Sabadell , Barcelona , Spain.
J Matern Fetal Neonatal Med. 2016 Dec;29(23):3870-4. doi: 10.3109/14767058.2016.1149566. Epub 2016 Mar 3.
To evaluate if ultrasound variables at term are associated with the mode of delivery in women with previous cesarean section (PCS).
This was a prospective study of singleton pregnant women who planned a trial of vaginal birth after cesarean delivery. Cervical length, posterior cervical angle, head-perineum distance, and estimated fetal weight were measured at 37-39 weeks of gestation.
One hundred forty-four pregnancies were examined and vaginal delivery was achieved in 98 women (73%). Logistic regression analysis identified cervical length, head-perineum distance, age, previous vaginal delivery, previous cesarean for dystocia, and Bishop score as predictors of vaginal delivery. Combining ultrasound and clinical parameters, two models for risk scoring that differ in the variable Bishop score or cervical length were constructed. The AUC of these models was 0.867 and 0.855, respectively.
In women with a PCS, measurement of cervical length and head-perineum distance at term is associated with the mode of delivery. A combination of clinical and sonographic parameters at term can predict the likelihood of vaginal delivery.
评估足月时超声变量与既往剖宫产（PCS）女性的分娩方式是否相关。
这是一项对计划剖宫产术后阴道试产的单胎孕妇进行的前瞻性研究。在妊娠37 - 39周时测量宫颈长度、宫颈后角、头 - 会阴距离和估计胎儿体重。
检查了144例妊娠，98名女性（73%）实现了阴道分娩。逻辑回归分析确定宫颈长度、头 - 会阴距离、年龄、既往阴道分娩史、既往因难产行剖宫产史和Bishop评分是阴道分娩的预测因素。结合超声和临床参数，构建了两种在变量Bishop评分或宫颈长度方面不同的风险评分模型。这些模型的AUC分别为0.867和0.855。
在有PCS的女性中，足月时宫颈长度和头 - 会阴距离的测量与分娩方式相关。足月时临床和超声参数的组合可以预测阴道分娩的可能性。
