Objective To explore the clinical value of three-dimensional ultrasound measurement of fetal head angle of progression(AOP)and fetal head-perineum-distance(HPD)in guiding delivery strategies during abnormal labor processes.Methods One hundred and sixty pregnant women who experienced abnormalities during vaginal trial delivery in Zhuhai Integrated Traditional Chinese and Western Medicine Hospita from August 2021 to February 2023 were prospectively selected,the postpartum women were divided into observation group(n=80)and control group(n=80)according to the random number table method.The observation group was given three-dimensional ultrasound monitoring to guide delivery,the control group received traditional vaginal digital examination guidance for delivery.The differences in delivery methods and adverse maternal and infant outcomes between the two groups were observed.The fetal head direction(HD),AOP,HPD,and midline angle(MLA)at the dilation of the cervix 4 cm and 2 h after dilation of the cervix 4 cm were analyzed.The predictive value of vaginal delivery in parturi-ents was analyzed using receiver operating characteristic(ROC)curves.The correlation between ultrasound parameters of vaginal delivery and de-livery duration in the observation group was analyzed.Results The proportion of vaginal delivery in the observation group was 82.50％,which was significantly higher than that in the control group(60.00％),the total incidence of adverse maternal and infant outcomes in the observation group was 7.50％,which was significantly lower than that in the control group(21.25％),the differences were statistically significant(P＜0.05).The AOP at the dilation of the cervix 4 cm and 2 h after dilation of the cervix 4 cm in the observation group were(114.45±11.02)° and(126.64±13.32)°,respectively,which were higher than those of cesarean section women[(101.43±9.98)° and(115.29±12.82)°],the HPD at 2 h after dilation of the cervix 4 cm was(26.76±4.43)mm,which was lower than that of cesarean section women[(30.10±4.13)mm],and the differences were statistically significant(P＜0.05).The area under the ROC curve predicted by AOP at the dilation of the cervix 4 cm for vaginal delivery was 0.819.The area under the ROC curve predicted by AOP and HPD at 2 h after dilation of the cervix 4 cm for vaginal delivery was 0.816 and 0.728,respectively.The AOP at the dilation of the cervix 4 cm of vaginal delivery women was negatively correlated with delivery duration(P＜0.05),while HPD at the dilation of the cervix 4 cm was positively correlated with delivery duration(P＜0.05).Conclusion Three-dimensional ultrasonic measurement has a good application value in guiding delivery during abnormal labor,which has the advantages of improving the vaginal delivery rate and reducing the occurrence of adverse maternal and infant outcomes.Meanwhile,AOP and HPD parameters have certain value in predicting vaginal delivery,and are related to the duration of labor.
关键词
三维超声/胎头进展角/胎头下降距离/异常产程
Key words
Three-dimensional ultrasound/Fetal head angle of progression/Fetal head-perineum-distance/Abnormal labor process
维普
万方数据