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第三孕期宫颈长度能否预测第一产程时间?

Does third trimester cervical length predict duration of first stage of labor?

机构信息

Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria.

Department of Medical Statistics, Medical University of Graz, Auenbruggerplatz 2, 8036, Graz, Austria.

出版信息

Wien Klin Wochenschr. 2019 Oct;131(19-20):468-474. doi: 10.1007/s00508-019-1527-0. Epub 2019 Jul 16.

Abstract

OBJECTIVE

To examine the association between third trimester cervical length (CL) measurement and duration of the first stage of labor.

METHODS

This prospective cohort study included women with a singleton pregnancy who had routine CL measurements taken by transvaginal ultrasonography between 37 and 39 weeks gestation. Subjective duration of the first stage of labor was defined as the duration of contractions that the women subjectively had from the onset of regular contractions to full effacement of the cervix. Objective duration of first stage of labor was defined as 3 cm cervical dilation independent of cervical effacement until full effacement of the cervix. Associations between variables were analyzed using nonparametric correlations coefficients. A model relating the duration of labor to predictors was built using linear regression.

RESULTS

In this analysis a total of 129 women were included. There was no significant correlation between CL and subjective duration of labor (ρ = -0.037, p = 0.695); however, a reduction in CL increased the objective duration of the first stage of labor (ρ = -0.269, p = 0.013). In univariate analysis parity (p = 0.018), hypertensive disorders (p = 0.013) and induction of labor (p = 0.022) were significantly associated with subjective duration of the first stage of labor.

CONCLUSION

A long cervix in the third trimester is not associated with a prolonged first stage of labor. Induction of labor and multiparity were associated with a shorter first stage of labor while hypertension was associated with a longer duration of labor.

摘要

目的

探讨妊娠晚期宫颈长度(CL)测量与第一产程持续时间的关系。

方法

本前瞻性队列研究纳入了单胎妊娠且在 37-39 孕周行经阴道超声进行常规 CL 测量的孕妇。第一产程的主观持续时间定义为孕妇从有规律宫缩开始至宫颈完全扩张的主观宫缩持续时间。第一产程的客观持续时间定义为 3cm 宫颈扩张且与宫颈扩张程度无关,直至宫颈完全扩张。采用非参数相关系数分析变量间的相关性。采用线性回归建立与产程相关的预测因素模型。

结果

本分析共纳入 129 名孕妇。CL 与主观产程持续时间之间无显著相关性(ρ= -0.037,p= 0.695);然而,CL 缩短会增加第一产程的客观持续时间(ρ= -0.269,p= 0.013)。单因素分析显示,产次(p= 0.018)、高血压疾病(p= 0.013)和引产(p= 0.022)与第一产程的主观持续时间显著相关。

结论

妊娠晚期宫颈较长与第一产程延长无关。引产和多产次与第一产程缩短有关,而高血压与产程延长有关。

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