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资源匮乏地区超声测量引产前置宫颈长度对分娩结局的影响

The Effect of Ultrasound-Measured Preinduction Cervical Length on Delivery Outcome in a Low-Resource Setting.

作者信息

Anikwe Chidebe C, Okorochukwu Bartholomew C, Uchendu Emmanuel, Ikeoha Cyril C

机构信息

Department of Obstetrics & Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi, Nigeria.

Department of Obstetrics and Gynaecology, Federal Medical Centre, Owerri, Imo, Nigeria.

出版信息

ScientificWorldJournal. 2020 May 1;2020:8273154. doi: 10.1155/2020/8273154. eCollection 2020.

DOI:10.1155/2020/8273154
PMID:32410909
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7211251/
Abstract

BACKGROUND

Induction of labour is not without risk, and it calls for a method that will be sensitive enough to predict successful labour induction.

AIM

This study aims to evaluate the role of transvaginal ultrasonographic cervical length measurement at term in the prediction of successful induction of labour (IOL).

MATERIALS AND METHODS

This prospective study was carried out in the Department of Obstetrics and Gynaecology of Federal Teaching Hospital Abakaliki between 1st of July and 30 of November 2015. Preinduction Bishop score and cervical length were assessed before induction of labour. Intracervical, cervical, extraamniotic Foley catheter was used to improve the Bishop score. The data were analyzed using the IBM SPSS Statistics 20.

RESULTS

The mean maternal age of the study group was 30.68 ± 6.38 years with a range of 19-43 years. The mean gestational age and parity were 39.57 ± 1.49 and 1.85 ± 0.63, respectively. All the women studied had successful induction of labour with mean induction delivery time of 8.1 ± 3.0 hours and mean duration of labour of 7.4 ± 2.9 hours. Preinduction cervical length is a good predictor of a short duration of labour ( = 0.001). Parturient with a preinduction cervical length of less than 3 cm was likely to have labour lasting less than 6 hours (RR = 4.20 (95% CI 1.85-9.529).

CONCLUSION

Transvaginal sonographic measurement of cervical length provides a useful prediction of the likelihood of duration of labour following the induction of labour. It is recommended that IOL should be considered and success anticipated in a parturient with a cervical length less than 3 cm.

摘要

背景

引产并非毫无风险,因此需要一种足够灵敏的方法来预测引产成功与否。

目的

本研究旨在评估足月时经阴道超声测量宫颈长度在预测引产成功方面的作用。

材料与方法

这项前瞻性研究于2015年7月1日至11月30日在阿巴卡利基联邦教学医院妇产科进行。引产前行Bishop评分及评估宫颈长度。采用宫颈内、宫颈、羊膜外Foley导管来改善Bishop评分。数据采用IBM SPSS Statistics 20进行分析。

结果

研究组产妇平均年龄为30.68±6.38岁,范围为19 - 43岁。平均孕周和产次分别为39.57±1.49和1.85±0.63。所有研究的妇女引产均成功,平均引产至分娩时间为8.1±3.0小时,平均产程为7.4±2.9小时。引产前行宫颈长度是产程短的良好预测指标(P = 0.001)。引产前行宫颈长度小于3 cm的产妇产程可能少于6小时(相对危险度=4.20(95%可信区间1.85 - 9.529))。

结论

经阴道超声测量宫颈长度可为引产后宫缩持续时间的可能性提供有用的预测。建议对于宫颈长度小于3 cm的产妇考虑引产并预期成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba5/7211251/5823253454cc/TSWJ2020-8273154.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba5/7211251/022bd4eaf330/TSWJ2020-8273154.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba5/7211251/a6d4b565f9d7/TSWJ2020-8273154.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba5/7211251/5823253454cc/TSWJ2020-8273154.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba5/7211251/022bd4eaf330/TSWJ2020-8273154.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba5/7211251/a6d4b565f9d7/TSWJ2020-8273154.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba5/7211251/5823253454cc/TSWJ2020-8273154.003.jpg

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The use of sonographic cervical length assessment for the prediction of time from induction to delivery.超声测量宫颈长度在预测引产至分娩时间方面的应用。
J Matern Fetal Neonatal Med. 2016;29(14):2332-6. doi: 10.3109/14767058.2015.1085018. Epub 2015 Oct 30.
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Methods for assessing pre-induction cervical ripening.
评估引产术前宫颈成熟度的方法。
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Oral versus vaginal misoprostol for induction of labor in Enugu, Nigeria: a randomized controlled trial.尼日利亚埃努古地区口服与阴道使用米索前列醇引产的随机对照试验
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Can measurement of cervical length, fetal head position and posterior cervical angle be an alternative method to Bishop score in the prediction of successful labor induction?测量宫颈长度、胎头位置和宫颈后角度能否作为预测引产成功的一种替代 Bishop 评分的方法?
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