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经会阴超声对分娩进展的准确评估可能会改善阴道分娩:一项单中心回顾性研究。

Accurate evaluation of the progress of delivery with transperineal ultrasound may improve vaginal delivery: a single-center retrospective study.

机构信息

Department of Obstetrics and Gynecology, Matsusaka Chuo General Hospital, 102 Kawaimachi, Matsusaka, Mie, Japan.

Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Mie, Japan.

出版信息

Sci Rep. 2023 Nov 28;13(1):20945. doi: 10.1038/s41598-023-47457-2.

Abstract

Although digital examination of the cervix is the standard method used worldwide for evaluating the progress of delivery, it is subjective. Transperineal ultrasound (TPU) is combined with digital evaluation for accurate assessment of fetal descent and rotation of the advanced part of the fetus. This retrospective study aimed to clarify the impact of introducing TPU on perinatal outcomes at Mie University Hospital. We analyzed singleton pregnant women who underwent delivery management at our hospital between April 2020 and March 2021. Perinatal outcomes were compared between patients who used TPU (TPU+ group) and those who did not (TPU- group). The angle of progression and head direction were measured. The rate of vaginal delivery was significantly increased (90.9% vs. 71.6%; P = 0.0017), and the second stage of labor was significantly prolonged in the TPU+ group (148.1 vs. 75.8 min; P < 0.0001). A significant difference was observed in termination in the latent phase between the TPU+ group [3/8 (37.5%) cases] and TPU- group [20/25 (80.0%) cases] (P = 0.036). The rate of vaginal delivery can be increased through accurate evaluation of the progress of delivery with TPU.

摘要

虽然宫颈数字化检查是全球用于评估分娩进展的标准方法,但它具有主观性。经会阴超声(TPU)与数字化评估相结合,可准确评估胎儿下降和先露部旋转。本回顾性研究旨在阐明在 Mie 大学医院引入 TPU 对围产结局的影响。我们分析了 2020 年 4 月至 2021 年 3 月在我院接受分娩管理的单胎孕妇。比较了使用 TPU(TPU+组)和未使用 TPU(TPU-组)的患者的围产结局。测量了进展角度和胎头方向。阴道分娩率显著增加(90.9% vs. 71.6%;P=0.0017),TPU+组的第二产程明显延长(148.1 vs. 75.8 分钟;P<0.0001)。TPU+组[3/8(37.5%)例]和 TPU-组[20/25(80.0%)例]在潜伏期的终止上存在显著差异(P=0.036)。通过 TPU 准确评估分娩进展,可以提高阴道分娩率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ad0/10684555/b0e5976952a5/41598_2023_47457_Fig1_HTML.jpg

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