三维超声断层成像技术评估晚孕期提肌裂孔大小与分娩进程的相关性探讨

王玥; 陈芸; 佘颖; 张雁; 曲侠; 张蒂荣

中国临床医学影像杂志 ›› 2012, Vol. 23 ›› Issue (5) : 338-341.

论著

三维超声断层成像技术评估晚孕期提肌裂孔大小与分娩进程的相关性探讨

王玥，陈芸，佘颖，张雁，曲侠，张蒂荣

作者信息 +

3D tomographic ultrasound imaging of the levator hiatus in late pregnancy and correlations with delivery outcomes

WANG Yue, CHEN Yun, SHE Ying, ZHANG Yan, QU Xia, ZHANG Di-rong

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文章历史 +

摘要

目的：探讨不同分娩进程与提肌裂孔大小间的相关性，从而为进行正常阴道分娩提供有用信息。方法：经检查为单胎妊娠，并适宜阴道分娩的孕36～40周初产妇67例。在孕36～40周进行4D超声检查，并离线进行三维超声断层成像技术（TUI）分析。在最小前后径平面测量最小生殖裂孔（LH）前后径（AP）、左右径（LR）、面积（A）。通过产科记录获得分娩过程中第二产程的时间，即宫颈内口完全开放至胎儿娩出的时间。结果：在阴道分娩中，第二产程时间长度的中位数是75 min（26～115 min）。第二产程的时长与提肌裂孔前后径在各种状态下都呈负相关（-0.40、-0.37、-0.38），与提肌裂孔面积在静息和Valsalval动作时呈负相关（-0.33、-0.39），而在肛提肌收缩状态下负相关不明显，同时左右径与产程长无相关性。结论：本研究阐明了初产妇提肌裂孔大小与分娩时第二产程呈负相关，检测提肌裂孔有助于临床医生判断第二产程，为客观评价产程进展及影响因素提供影像学支持。

Abstract

Objective: To determine the correlations between dimensions of the levator hiatus in late pregnant nulliparous women and mode of delivery, including length of second stage. Methods: This was a prospective observation study of 67 nulliparous women examined between 36 and 40 weeks of pregnancy. A translabial ultrasound examination was performed, and three-dimensional volume comprising the levator hiatus was recorded at rest, during a pelvic floor muscle contraction and on Valsalva. The volumes were analyzed in a blinded fashion using TUI to determine linear dimensions and hiatal area. Information regarding delivery outcomes and courses of labour was obtained from the obstetric database. Statistical analysis was undertaken for correlations between hiatal dimensions and labour outcomes. Results: No consistent correlation was found between levator dimensions and delivery mode. However, a negative correlation was demonstrated between the area of the hiatus, particularly on pelvic floor contraction, and length of total second stage. Conclusions: Levator hiatal dimensions are associated with the length of the second stage of labour. Although the number was small, our findings suggest that the effect of pelvic floor structures on progress in labour is worth of further study.

导出引用

王玥;陈芸;佘颖;张雁;曲侠;张蒂荣. 三维超声断层成像技术评估晚孕期提肌裂孔大小与分娩进程的相关性探讨[J]. 中国临床医学影像杂志. 2012, 23(5): 338-341

WANG Yue;CHEN Yun;SHE Ying;ZHANG Yan;QU Xia;ZHANG Di-rong. 3D tomographic ultrasound imaging of the levator hiatus in late pregnancy and correlations with delivery outcomes[J]. Journal of China Clinic Medical Imaging. 2012, 23(5): 338-341

中图分类号： Ｒ714.3 Ｒ445.1