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目的:探讨经阴道超声测量宫颈长度在足月初产妇宫颈成熟度诊断中的临床价值。方法:选择2012年12月~2014年5月在该院进行产前检查并住院分娩的98例足月初产妇的临床资料进行回顾性分析,采用阴道超声测量宫颈长度、宫颈管宽度及宫颈内口契形区宽度,并采用传统阴道指检进行Bishop评分来判断宫颈成熟度,并研究其对分娩方式的影响。结果:超声测量引产前宫颈平均长度为(25.8±7.3)mm,宫颈平均宽度为(3.5±2.2)mm,内口开大的有12例,占12.24%。引产前Bishop平均评分(4.6±1.2)分。98例产妇引产成功88例,引产失败10例,其中经阴道分娩50例,剖宫产48例,剖宫产率为48.98%。引产成功的产妇引产的平均潜伏期为(12±8)h,阴道分娩的平均产程为(13±8)h;宫颈长度<30 mm的产妇引产潜伏期显著短于宫颈长度≥30 mm的产妇,差异有统计学意义(P<0.05),而阴道分娩的产程差异无统计学意义(P>0.05);宫颈长度<30 mm的产妇较宫颈长度≥30 mm的产妇剖宫产率低。结论:经阴道超声测量宫颈长度判断足月初产妇宫颈成熟度及预测分娩方式显著优于传统的Bishop评分法,值得在临床上推广使用。
Objective: To investigate the clinical value of transvaginal ultrasonography in the diagnosis of cervical maturity of term primipara. Methods: The clinical data of 98 full-term primipara from December 2012 to May 2014 in our hospital for prenatal examination and in-hospital delivery were retrospectively analyzed. The length of cervical canal, the width of cervical canal, The width of the deformity zone, and the use of traditional vaginal examination Bishop score to determine the degree of cervical maturity, and study its impact on mode of delivery. Results: The average length of cervical before induction of labor was (25.8 ± 7.3) mm, the average width of cervix was (3.5 ± 2.2) mm, and the number of open mouth was 12, accounting for 12.24%. Pre-induction Bishop average score (4.6 ± 1.2) points. 98 cases of maternal successful induction of labor in 88 cases, induced abortion in 10 cases, of which vaginal delivery in 50 cases, 48 cases of cesarean section, cesarean section rate of 48.98%. The average incubation period for induction of labor was (12 ± 8) h and that for vaginal delivery was (13 ± 8) h. The latent period for induction of labor was significantly shorter for women with cervical length <30 mm than for women with cervical length ≥30 mm (P <0.05), while the labor duration of vaginal delivery had no significant difference (P> 0.05). The women with cervical length less than 30 mm had lower cesarean section rate than those with cervical length≥30 mm. Conclusion: Transvaginal ultrasound to measure the length of the cervix to determine the full-term primipara cervix maturity and predictive delivery method is significantly better than the traditional Bishop score, it is worth to promote the use of the clinic.