Department of Obstetrics and Gynecology, The Affiliated Drum and Tower Hospital of Medical School of Nanjing University, Nanjing, China.
Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.
Int J Gynaecol Obstet. 2022 Jan;156(1):28-33. doi: 10.1002/ijgo.13605. Epub 2021 Feb 9.
To construct an ultrasound partogram using serial transperineal sonographic measurements of the angle of fetal head progression during the first stage of labor, and to compare it with a conventional partogram based on digital vaginal examinations.
Between 2017 and 2018, a prospective cohort study at Drum Tower Hospital, Nanjing, China, recruited 375 nulliparous women with singleton pregnancy and spontaneous onset of labor at 37 or more gestational weeks. Transperineal ultrasound scans were performed to measure the angle of progression (AoP) every 0.5-1 h until the second stage. Vaginal examinations were also used to measure cervical dilatation. Repeated-measures analysis was used to generate labor curves.
The labor curve generated by AoP had a pattern similar to that based on cervical dilatation. There was an initial slow period lasting approximately 5.5 h until the cervical dilatation or AoP reached the inflection point (4 cm and 119°, respectively), followed by a second, more rapid period, lasting approximately 2.5 h.
Based on ultrasound data, it was feasible to construct an "angle of progression partogram" of the first stage of labor, which was similar in pattern to the partogram based on cervical dilatation measured in the same cohort.
利用经会阴超声测量胎头在产程第一阶段进展的角度，构建超声产程图，并与基于数字化阴道检查的传统产程图进行比较。
2017 年至 2018 年，在中国南京鼓楼医院进行了一项前瞻性队列研究，共招募了 375 名初产妇，单胎妊娠，妊娠 37 周及以上自然临产。在第二产程之前，每隔 0.5-1 小时经会阴超声扫描测量进展角度（AoP）。还进行阴道检查测量宫颈扩张度。采用重复测量分析生成产程曲线。
AoP 生成的产程曲线与基于宫颈扩张度的曲线模式相似。首先是大约 5.5 小时的缓慢期，直到宫颈扩张或 AoP 达到拐点（分别为 4cm 和 119°），然后是第二个更快的时期，持续大约 2.5 小时。
基于超声数据，构建产程第一阶段的“进展角度产程图”是可行的，其模式与同一队列中基于数字化阴道检查测量的宫颈扩张度产程图相似。
