Widschwendter Peter, Lato Krisztian, Friedl Thomas W P, Janni Wolfgang, Friebe-Hoffmann Ulrike
Frauenklinik, Klinikum der Universität Ulm, Ulm, Germany.
Geburtshilfe Frauenheilkd. 2018 Sep;78(9):859-865. doi: 10.1055/a-0659-6873. Epub 2018 Sep 14.
The value of foetal Doppler ultrasonography before induction of labour for prognostic assessment of the duration of labour and foetal outcome is presented. Doppler ultrasound of the foetal middle cerebral artery (MCA) and of the umbilical artery (UA) was performed in addition to evaluation of the Bishop score in 49 women around the expected date of confinement (38 + 0 - 42 + 0 weeks of gestation) prior to planned pharmacological induction of labour. These parameters were studied using non-parametric statistical methods for associations with the duration of induction until delivery, the mode of delivery and foetal outcome. The resistance index (RI) of the MCA (rs = 0.547, p < 0.001), but not the RI of the UA (rs = - 0.055, p = 0.707) correlated positively with the duration of induction. Moreover, a negative correlation was found between the RI of the UA and the baby's arterial cord pH at birth (rs = - 0.287, p = 0.046). No differences in the RI of MCA or UA were found between babies born vaginally and those delivered by secondary section. The present data show that Doppler measurement of the foetal MCA and UA before pharmacological induction of labour at term can be a further parameter for prognostic estimation of the duration and success of induction and of foetal outcome in addition to the established Bishop score.
本文介绍了引产之前进行胎儿多普勒超声检查对产程持续时间和胎儿结局进行预后评估的价值。在计划进行药物引产之前,对49名预产期(妊娠38 + 0至42 + 0周)左右的孕妇,除了评估Bishop评分外,还进行了胎儿大脑中动脉(MCA)和脐动脉(UA)的多普勒超声检查。使用非参数统计方法研究这些参数与引产至分娩的持续时间、分娩方式和胎儿结局之间的关联。MCA的阻力指数(RI)(rs = 0.547,p < 0.001)与引产持续时间呈正相关,而UA的RI(rs = -0.055,p = 0.707)则无此相关性。此外,发现UA的RI与出生时婴儿的脐动脉血pH值呈负相关(rs = -0.287,p = 0.046)。经阴道分娩的婴儿与经二次剖宫产分娩的婴儿之间,MCA或UA的RI没有差异。目前的数据表明,足月药物引产之前对胎儿MCA和UA进行多普勒测量,除了已有的Bishop评分外,还可以作为引产持续时间和成功率以及胎儿结局预后评估的进一步参数。