子宫颈角度能否成功预测初产妇的引产情况？
Can uterocervical angles successfully predict induction of labor in nulliparous women?
作者信息
Dagdeviren Emrah, Aslan Çetin Berna, Aydogan Mathyk Begum, Koroglu Nadiye, Topcu Elif Goknur, Yuksel Mehmet Aytac
机构信息
Kanuni Sultan Suleyman Research and Training Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.
Kanuni Sultan Suleyman Research and Training Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.
出版信息
Eur J Obstet Gynecol Reprod Biol. 2018 Sep;228:87-91. doi: 10.1016/j.ejogrb.2018.06.014. Epub 2018 Jun 11.
PURPOSE
Induction of labor is a common practice in obstetrics. In recent years, a newer ultrasonographic parameter called the uterocervical angle (UCA) has been identified as a predictive tool for births. Our purpose is to investigate the role of UCA in predicting successful induction of labor.
METHODS
The nulliparous term pregnancies (n:150) were grouped into successful/failed inductions of labor based on their progress into the active phase of labor after the administration of prostaglandin E2 (dinoprostone). The pre-induction cervical length (CL) and UCA were compared in the two groups. The study population was further grouped according to their modes of delivery and pre-induction UCAs were compared among the subgroups.
RESULTS
The mean UCAs were not significant among the successful induction and failed induction groups (105.46 ± 20.54 degrees in the successful group and 110.57 ± 13.46 degrees in the failed group). However, UCAs significantly varied among the modes of delivery subgroups. The median UCA was significantly higher in patients who delivered vaginally after a successful induction of labor than in patients who delivered via cesarean section. The median UCA value was lowest in patients who had a successful induction of labor but ended up having a cesarean section (Fig. 2). Further, the duration of the active phase of labor negatively correlated with the UCA but not the CL (rho=-0.23, p = 0.02). There was also a negative correlation between the CL and the UCA in patients who delivered vaginally after successful induction of labor (rho= -0.21, p = 0.03).
CONCLUSION
The UCA is a promising ultrasonographic marker in obstetrics. Although the pre-induction UCA did not predict the outcome of labor induction, patients with broader pre-induction UCAs were prone to have a shorter duration of active phase. The pre-induction CL and UCA are inversely corraleted in nulliparous women who delivered vaginally after a successful induction of labor.
目的
引产是产科常见的操作。近年来，一种名为子宫颈角度（UCA）的新超声参数已被确定为预测分娩的工具。我们的目的是研究UCA在预测引产成功中的作用。
方法
将初产妇足月妊娠（n = 150）根据给予前列腺素E2（地诺前列酮）后进入产程活跃期的进展情况分为引产成功/失败组。比较两组引产前置宫颈长度（CL）和UCA。根据分娩方式对研究人群进一步分组，并比较各亚组的引产前置UCA。
结果
引产成功组和失败组的平均UCA无显著差异（成功组为105.46±20.54度，失败组为110.57±13.46度）。然而，UCA在分娩方式亚组间有显著差异。引产成功后经阴道分娩的患者中位UCA显著高于剖宫产患者。引产成功但最终行剖宫产的患者中位UCA值最低（图2）。此外，产程活跃期的持续时间与UCA呈负相关，与CL无关（rho = -0.23，p = 0.02）。引产成功后经阴道分娩的患者CL与UCA之间也存在负相关（rho = -0.21，p = 0.03）。
结论
UCA是产科一种有前景的超声标志物。尽管引产前置UCA不能预测引产结果，但引产前置UCA较宽的患者活跃期持续时间较短。引产成功后经阴道分娩的初产妇引产前置CL与UCA呈负相关。
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