应用阴道超声测量骨盆及胎头径线指数预测相对头盆不称的研究.pdfVIP

中华妇产科杂志/980906 中华妇产科杂志 科技期刊 CHINESE JOURNAL OF OBSTETRICS AND GYNECOLOGY 1998年9月　第33卷　第9期 * 论著* 应用阴道超声测量骨盆及胎头径线指数 预测相对头盆不称的研究 边旭明　庄槿　程雪梅 　　【摘要】　目的　探讨应用阴道超声测量胎儿头盆指数，诊断相对头盆不称的方法。方法　 对190例初产妇分为阴道分娩组(117例)和手术分娩组(73例)。在孕28～35周时应用阴道超声行骨盆 测量，在分娩前1周行超声测量胎儿双顶径和头围，计算出径线，周长和面积的头盆指数，并与 分娩结果比较。结果　各种头盆指数在手术分娩组和阴道分娩组间均有显著性差异。其中定义为 骨盆中腔前后径与横径的均值与胎儿双顶径之差的径线头盆指数(CID)准确率最高(77.9%)。 CID≤15.8 mm时，83.0%的孕妇需手术分娩，CID15.8 mm时，72.6%的孕妇可顺利经阴道分娩。 结论　应用阴道超声行骨盆测量和CID预测相对头盆不称，是一种简单实用的方法，可协助产科 临床恰当地选择分娩方式。 　　【关键词】　分娩并发症　　超声检查　　骨盆测量法 Prediction of Cephalopelvic Disproportion by Ultrasonographic Cephalopelic 　Bian Xuming, Zhuang Jin, Cheng Xuemei. Peking Union Medical College Hospital, Beijing 100730 　　【Abstract 】　Objective　To develop a prospective antepartum method of identifying cephalopelvic disproportion by comparing the diameters of fetal head with those of the maternal midpelvis. Methods　Transvaginal ultrasound pelvimetry was performed on 190 healthy primigravidas with cephalic presentation at 28～35 weeks of gestation, and the diameters of their fetal heads were meassured within one week prior to delivery. These indices the cephalopelvic indices of diameter, cirumference and area, were calculated and compared. Results　The cephalopelvic index of diameter (CID), defined as the difference between the mean diameter of the midpelvis and the fetal biparetal diaameter (BPD), showed the highest degree of accuracy (77.9%). Eighty three percent of woomen with CID less than 15.8 needed operative delivery; 76.2% of those with CId more than 15.8 mm underwent vaginal delivery. Conclusions　Transvaginal ultrasound pelvimetry and the CID by and large seems to be able to identify cephalopelvic disproportion before l