摘要
目的探讨经会阴超声动态监测宫颈管长度,从而为完全性前置胎盘适时终止妊娠提供临床指导。方法选取2014年1月至2017年10月嘉兴市妇女儿童医院收治的孕28~30周的完全性前置胎盘患者130例,其中试验组66例,对照组64例,入院保胎过程中,严密监测患者生命体征、腹痛腹胀、阴道流血及胎儿宫内情况。试验组入院用药2、12h通过经会阴超声监测宫颈管长度,从而指导终止妊娠时机,对照组根据患者腹痛腹胀症状缓解与否及阴道出血量来指导终止妊娠时机。比较两组母胎预后。结果试验组患者入院时宫颈管长度为(31.3±1.3)mm,应用保胎药物2及12h后宫颈管长度依次为(32.1±0.4)mm及(32.2±0.4)mm,与入院时宫颈长度相比,应用保胎药物2及12h后宫颈管长度无明显变化(均P>0.05);试验组11例患者分娩孕周未超过34周,对照组则为28例,两者比较差异有统计学意义。与对照组相比,试验组新生儿≤34周分娩率、出生体质量及住院时间差异明显减少(均P<0.05)。但两组患者产妇结局差异无统计学意义。结论经会阴超声监测宫颈管长度能较好指导完全性前置胎盘分娩时机的决策。
Objective To investigate the value of dynamic monitoring of cervical canal length by transperineal ultrasonography in the decision-making of the timing of delivery in patients with complete placenta previa,then to provide clinical guidance for complete termination of placenta.MethodsA total of 130 patients with complete placenta previa from 28 weeks to 30 weeks of gestation between January 2014 and October 2017 in Jiaxing Maternal and Child Health Hospital were selected.There were 66 patients in the experimental group and 64 in the control group,closely monitor the patient′s vital signs,abdominal pain,abdominal distension,vaginal bleeding and fetal intrauterine conditions.In the experimental group,the length of the cervical canal was monitored by perineal ultrasonography at 2 hours and 12 hours after admission.This led to termination of the pregnancy.The control group was instructed to terminate the timing of pregnancy based on the patient′s abdominal pain relief symptoms and vaginal bleeding.Compare the maternal and fetal outcomes of both groups.Results The length of the cervical canal was(31.3±1.3)mm when the experimental group was admitted to the hospital,and the length of the cervical canal after the use of the retention drugs 2 h and 12 h was(32.1±0.4)mm and(32.2±0.4)mm,respectively.Compared with the length of the cervix at the time of admission.There was no significant change in the length of the cervical canal after the application of the retention drug 2 and 12 h(all P>0.05).The delivery week of 11 patients in the experimental group did not exceed 34 weeks,and 28 cases in the control group,and there was significant difference between the two groups.Compared with the control group,the difference of birth rate did not exceed 34 weeks,birth weight and hospitalization time decreased significantly(all P<0.05).However,there was no significant difference in maternal outcomes between the two groups.ConclusionThrough monitoring the length of the cervical canal by perineal ultrasound can make a better decision for the patients of complete placenta previa to chose the time of delivery.
作者
沈红丽
超蔚
朱巍立
钟少平
朱伟英
Shen Hongli;Zhao Wei;Zhu Weili;Zhong Shaoping;Zhu Weiying(Department of Obstetrics,Jiaxing Women and Children's Hospital of Wenzhou Medical University,Jiaxing 314000,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2019年第11期834-837,共4页
National Medical Journal of China
基金
浙江省医药卫生科技计划项目(2016KYB283)
嘉兴市科技局基金资助项目(2015AY23031).
关键词
会阴超声
宫颈管长度
前置胎盘
Transperineal ultrasonography
The length of the cervical canal
Placenta previa
