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经会阴超声测量产程中的进展角度以预测初产妇的分娩方式。

Measurement of angle of progression by trans perineal-ultrasound in labour to predict mode of delivery in nulliparous women.

作者信息

Masood Humaira, Abid Rubaba, Ahmed Mohammad, Mehmood Munir

机构信息

Humaira Masood Senior Registrar, Department of Obstetrics and Gynaecology, Benazir Bhutto Hospital Rawalpindi Medical University, Rawalpindi, Pakistan.

Rubaba Abid Associate Professor, Department of Obstetrics and Gynaecology, Benazir Bhutto Hospital Rawalpindi Medical University, Rawalpindi, Pakistan.

出版信息

Pak J Med Sci. 2025 Jan;41(1):147-150. doi: 10.12669/pjms.41.1.9930.

DOI:10.12669/pjms.41.1.9930
PMID:39867802
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11755286/
Abstract

OBJECTIVE

The objective of the study was to assess whether the measurement of the angle of progression in nulliparous women in labour can predict the mode of delivery.

METHODS

This prospective observational study was conducted at Benazir Bhutto Hospital, Rawalpindi Medical University from 16 February to 25 March 2024. Nulliparous pregnant women in the active first stage of labour with singleton pregnancy and cephalic presentation were included in the study after taking informed consent. The angle of progression (AOP) was measured by trans-perineal ultrasound using the curvilinear probe. The primary outcome was the mode of delivery in relation to angle of progression.

RESULTS

Seventy-eight patients were included in the study. Angle of progression was wider in patients who underwent vaginal delivery and narrower in patients who underwent cesarean section. AOP of 121 or more is associated with 86.6% of vaginal delivery and an angle of progression of 70 or less is associated with 83.3% of cesarean section.

CONCLUSION

The angle of progression is a reliable tool for predicting the mode of delivery. Wider angle is associated with vaginal delivery and a narrower angle is associated with cesarean section.

摘要

目的

本研究的目的是评估未产妇分娩时进展角度的测量是否能预测分娩方式。

方法

这项前瞻性观察性研究于2024年2月16日至3月25日在拉瓦尔品第医科大学贝娜齐尔·布托医院进行。在获得知情同意后,纳入处于活跃第一产程、单胎妊娠且头先露的未产妇。使用曲线探头经会阴超声测量进展角度(AOP)。主要结局是与进展角度相关的分娩方式。

结果

78名患者纳入研究。经阴道分娩患者的进展角度较宽,剖宫产患者的进展角度较窄。进展角度为121或更大与86.6%的阴道分娩相关,进展角度为70或更小与83.3%的剖宫产相关。

结论

进展角度是预测分娩方式的可靠工具。角度较宽与阴道分娩相关,角度较窄与剖宫产相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5419/11755286/ab04ffa3ce65/PJMS-41-147-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5419/11755286/133f21047d7d/PJMS-41-147-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5419/11755286/ab04ffa3ce65/PJMS-41-147-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5419/11755286/133f21047d7d/PJMS-41-147-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5419/11755286/ab04ffa3ce65/PJMS-41-147-g002.jpg

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本文引用的文献

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Obstet Gynecol Sci. 2024 Jan;67(1):1-16. doi: 10.5468/ogs.23141. Epub 2023 Nov 29.
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Prognostic accuracy of ultrasound measures of fetal head descent to predict outcome of operative vaginal birth: a comparative systematic review and meta-analysis.超声测量胎头下降预测经阴道分娩结局的准确性:比较系统评价和荟萃分析。
Am J Obstet Gynecol. 2023 Jul;229(1):10-22.e10. doi: 10.1016/j.ajog.2022.11.1294. Epub 2022 Nov 23.
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Intrapartum ultrasound measurement of angle of progression at the onset of the second stage of labor for prediction of spontaneous vaginal delivery in term singleton pregnancies: a systematic review and meta-analysis.
产程中第二产程起始时进展角度的超声测量预测足月单胎妊娠阴道分娩的效果:系统评价和荟萃分析。
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The role of the angle of progression in the prediction of the outcome of occiput posterior position in the second stage of labor.在第二产程中,胎方位为枕后位时,进展角度对分娩结局的预测作用。
Am J Obstet Gynecol. 2021 Jul;225(1):81.e1-81.e9. doi: 10.1016/j.ajog.2021.01.017. Epub 2021 Jan 25.
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Measurement of Angle of Descent (AOD) by Transperineal Ultrasound in Labour to Predict Successful Vaginal Delivery.经会阴超声测量产程中下降角度(AOD)以预测阴道分娩成功与否。
J Obstet Gynaecol India. 2020 Apr;70(2):126-132. doi: 10.1007/s13224-019-01300-9. Epub 2020 Jan 2.
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ISUOG Practice Guidelines: intrapartum ultrasound.国际妇产科超声学会实践指南:产时超声。
Ultrasound Obstet Gynecol. 2018 Jul;52(1):128-139. doi: 10.1002/uog.19072.
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Automated Measurement of the Angle of Progression in Labor: A Feasibility and Reliability Study.分娩过程中进展角度的自动测量:一项可行性和可靠性研究。
Fetal Diagn Ther. 2017;41(4):293-299. doi: 10.1159/000448947. Epub 2016 Sep 3.
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