Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
J Ultrasound Med. 2024 Dec;43(12):2339-2344. doi: 10.1002/jum.16568. Epub 2024 Sep 4.
This study aims to explore the correlation between the angle of progression (AOP) and spontaneous vaginal delivery (SVD) for term nulliparous women before the onset of labor. Additionally, it evaluates the diagnostic efficacy of AOP in predicting SVD in term nulliparous women.
In this retrospective observational study, data from nulliparous women without contraindications for vaginal delivery, with a singleton pregnancy ≥37 weeks, and before the onset of labor were included. Transperineal ultrasound was performed to collect AOP. The date and mode of delivery were tracked, to assess the correlation between AOP and SVD in term nulliparous women. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of AOP in predicting SVD for term nulliparous women.
The SVD-failure (SVD-f) group exhibited a significantly lower AOP compared with the SVD group (88.43° vs 95.72°, P < .001). Logistic regression analysis revealed that AOP was associated with SVD in term nulliparous women (OR = 1.051). ROC curve analysis demonstrated that the area under the ROC curve with AOP 84° as the threshold was 0.663, with a sensitivity of 85.25% and specificity of 43.18%. Considering a sensitivity and specificity of 90%, the dual cut-off values for term nulliparous women for SVD were 81° and 104°, respectively.
A positive correlation was identified between AOP and SVD for nulliparous women after 37 weeks and before the onset of labor. Notably, term nulliparous women with AOP exceeding 104° exhibited a higher probability of SVD.
本研究旨在探讨足月初产妇未临产时的进展角度（AOP）与自然分娩（SVD）的相关性，并评估 AOP 预测足月初产妇 SVD 的诊断效能。
本回顾性观察性研究纳入无阴道分娩禁忌、单胎妊娠≥37 周且未临产的初产妇。经会阴超声采集 AOP。跟踪记录分娩日期和分娩方式，评估足月初产妇 AOP 与 SVD 的相关性。采用受试者工作特征（ROC）曲线分析评估 AOP 预测足月初产妇 SVD 的诊断效能。
SVD 失败（SVD-f）组的 AOP 明显低于 SVD 组（88.43° vs 95.72°，P<0.001）。Logistic 回归分析显示 AOP 与足月初产妇的 SVD 相关（OR=1.051）。ROC 曲线分析表明，AOP 为 84°时的 ROC 曲线下面积为 0.663，灵敏度为 85.25%，特异性为 43.18%。考虑灵敏度和特异性均为 90%，足月初产妇 SVD 的双截断值分别为 81°和 104°。
足月初产妇未临产时 AOP 与 SVD 呈正相关。重要的是，AOP 超过 104°的足月初产妇发生 SVD 的可能性更高。
