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剖宫产时难产的一种可能预测:臀肌挛缩,来自中国的单中心经验

A possible prediction of dystocia at the time of cesarean delivery: Gluteal muscle contracture, a single center experience from China.

作者信息

You Tian, Yang Bei, Zhang Xin-Tao, Ren Shi-You, Bai Lu, Jiao Fu-Jia, Jiang Xiao-Cheng, Guan Si-Yao, Zhang Wen-Tao

机构信息

Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital.

Gynecology Department, Shenzhen Nanshan Maternity and Child Healthcare Hospital, Shenzhen, China.

出版信息

Medicine (Baltimore). 2020 Feb;99(7):e19138. doi: 10.1097/MD.0000000000019138.

Abstract

The study assessed the pelvic dimensions by computed tomography (CT) performed for gluteal muscle contracture women, and evaluated the impact of malformations on several essential obstetric parameters.The CT pelvimetry was retrospectively performed in 25 gluteal muscle contracture women selected consecutively whether they had delivery history or not. Among the pelvic inlet plane, the mid plane and the outlet plane, 12 indicators including the transverse diameter of the pelvic inlet, the conjugate vera, the diagonal conjugate, the biischial diameter, the anteroposterior diameter of the middle pelvis, transverse outlet, the posterior sagittal diameter of outlet, the conjugate of the outlet, the anterior sagittal diameter of the outlet, the curvature and length of the sacrum, the angle of pubic arch were collected.Finally, the mean age of these women was 26.6 ± 5.0 years. Most pelvises had anteroposterior elliptical appearance in inlet and size of the female pelvis. The most statistically different and most clinically significant indicator was the biischial diameter, gluteal muscle contracture women were 95.6 ± 9.3 mm and the normal women from other study were 105.0 ± 7.9 mm, the comparison showed a significant difference (P < .001).Generally, most gluteal muscle contracture women had features of anthropoid pelvis which were quite different from normal Chinese female. These results may serve as a basis for future studies to assess its utility and prognostic value for a safe vaginal delivery in gluteal muscle contracture women.

摘要

该研究通过计算机断层扫描(CT)评估臀肌挛缩女性的骨盆尺寸,并评估畸形对几个重要产科参数的影响。对25例连续入选的有或无分娩史的臀肌挛缩女性进行了回顾性CT骨盆测量。在骨盆入口平面、中平面和出口平面中,收集了包括骨盆入口横径、真结合径、对角径、坐骨结节间径、中骨盆前后径、出口横径、出口后矢状径、出口共轭径、出口前矢状径、骶骨曲率和长度、耻骨弓角度在内的12项指标。最后,这些女性的平均年龄为26.6±5.0岁。大多数骨盆在入口处呈前后椭圆形,且为女性骨盆大小。统计学上差异最大且临床上最显著的指标是坐骨结节间径,臀肌挛缩女性为95.6±9.3mm,其他研究中的正常女性为105.0±7.9mm,比较显示差异有统计学意义(P<0.001)。一般来说,大多数臀肌挛缩女性具有类人猿型骨盆的特征,这与正常中国女性有很大不同。这些结果可为未来评估其在臀肌挛缩女性安全阴道分娩中的效用和预后价值的研究提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4cd/7035071/9c8af0d6809d/medi-99-e19138-g001.jpg

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