经阴道虚拟触诊定量在预测引产结局中的作用。

USEFULNESS OF TRANSPERINEAL VIRTUAL TOUCH QUANTIFICATION IN THE CERVIX FOR PREDICTING OUTCOME OF LABOR INDUCTION.

机构信息

Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China.

Department of Ultrasound, Rizhao People's Hospital, Rizhao 276500, Shandong, China.

出版信息

Ultrasound Med Biol. 2020 Sep;46(9):2207-2214. doi: 10.1016/j.ultrasmedbio.2020.04.037. Epub 2020 Jun 18.

DOI:10.1016/j.ultrasmedbio.2020.04.037

PMID:32565129

Abstract

This study aimed to explore the feasibility of transperineal virtual touch tissue quantification (VTQ) for predicting the outcome of labor induction. A total of 80 nulliparous pregnant women were included. Before labor induction, cervical length was measured by B-mode sonography, cervical stiffness was measured by VTQ, and Bishop score was assessed by vaginal examination. Subsequently, labor was induced using standard oxytocin infusion in all patients. Delivery within 24 hours after labor induction was classified as spontaneous delivery; otherwise, cesarean delivery was performed. Out of 80 participants, 48 (60%) delivered vaginally and 32 (40%) underwent cesarean delivery. The cervical length was significantly longer and the shear wave velocity (SWV) was greater in the cesarean delivery group than in the vaginal delivery group (p = 0.004 and p < 0.000, respectively). Logistic regression analysis indicated that only the mean SWV had independent predictive value for the outcome of labor induction (p = 0.011). The best diagnostic cut-off point of the mean SWV was 1.23 m/s, with a sensitivity of 93.8% and a specificity of 89.6%. Transperineal VTQ technique could predict the outcome of labor induction using oxytocin.

摘要

本研究旨在探讨经会阴虚拟触诊组织定量技术（VTQ）预测引产结局的可行性。共纳入 80 例初产妇。在引产前，通过 B 型超声测量宫颈长度，通过 VTQ 测量宫颈硬度，通过阴道检查评估 Bishop 评分。随后，所有患者均采用标准缩宫素静脉滴注引产。引产 24 小时内分娩者为自然分娩，否则行剖宫产术。80 例患者中，48 例（60%）经阴道分娩，32 例（40%）行剖宫产术。剖宫产组的宫颈长度明显长于阴道分娩组，剪切波速度（SWV）也明显高于阴道分娩组（p=0.004 和 p<0.000，分别）。Logistic 回归分析表明，只有平均 SWV 对引产结局有独立的预测价值（p=0.011）。平均 SWV 的最佳诊断截断值为 1.23m/s，其灵敏度为 93.8%，特异性为 89.6%。经会阴 VTQ 技术可预测催产素引产的结局。