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晚期妊娠动态外骨盆测量试验能否揭示产程梗阻和延长?一项初步研究的结果。

Can the Dynamic External Pelvimetry Test in Late Pregnancy Reveal Obstructed and Prolonged Labor? Results From a Pilot Study.

作者信息

Siccardi Marco, Valle Cristina

机构信息

Obstetrics and Gynecology, Primal Osteopathy Institute, Savona, ITA.

Obstetrics and Gynecology, San Paolo Hospital, Savona, ITA.

出版信息

Cureus. 2021 Dec 21;13(12):e20566. doi: 10.7759/cureus.20566. eCollection 2021 Dec.

Abstract

Background The size and mobility of the maternal pelvic space are fundamental factors in successful childbirth and can allow operators to screen for dystocia. This pilot study including a group of 70 pregnant women aimed to test whether the external dynamic pelvimetry test can be used to predict the likelihood of obstructed labor. Methodology The study cohort consisted of 70 pregnant women in their third trimester. The cohort was divided retrospectively into an obstructed labor group and a control group. Obstructed labor was defined using the following obstetric outcomes: augmentation with oxytocin from the first phase of the dilating period, Kristeller's maneuvers, vacuum extractor (kiwi), forceps, and the cesarean section following the onset of labor. Results The measurements obtained for the longitudinal hemi-diameter of Michaelis, the inter-tuberous diameter, and the base of the Trillat's triangle were statistically significant in every position. The difference in the measurements of the transverse diameter of Michaelis between standing and hands-and-knees position and the difference in the sizes of the bi-cristal diameter between hands-and-knees and squatting position were statistically significant. Conclusions Dimension and biomechanical properties of the pelvic tissue and spaces influence the evolutionary childbirth process. After clinical confirmation on a large population, hypomobility of specified external pelvic diameters measured in shifting positions can become a screening tool to detect the contracted pelvis and prevent damage caused by dystocia and prolonged labor in women and newborns.

摘要

背景

产妇骨盆空间的大小和可动性是成功分娩的基本因素,可使医护人员筛查难产情况。这项包含70名孕妇的试点研究旨在测试外部动态骨盆测量试验是否可用于预测梗阻性分娩的可能性。

方法

研究队列由70名孕晚期孕妇组成。该队列被回顾性地分为梗阻性分娩组和对照组。梗阻性分娩通过以下产科结局来定义:从扩张期第一阶段开始使用缩宫素加强宫缩、克里斯特勒手法、真空吸引器(奇异果)、产钳以及分娩开始后的剖宫产。

结果

所测得的米氏纵半径、坐骨结节间径和特里拉特三角底边在各个位置上均具有统计学意义。站立位与手膝位之间米氏横径测量值的差异以及手膝位与蹲位之间双髂嵴间径大小的差异具有统计学意义。

结论

骨盆组织和空间的尺寸及生物力学特性会影响分娩的进化过程。在对大量人群进行临床验证后,在不同体位下测得的特定外部骨盆直径活动度降低可成为一种筛查工具,用于检测骨盆狭窄,并预防难产和产程延长对产妇及新生儿造成的损害。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6402/8772530/f19e5e148964/cureus-0013-00000020566-i01.jpg

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