现代妇产科进展2016，Vol.25Issue(9)：676-679,4.DOI:10.13283/j.cnki.xdfckjz.2016.09.007
超声测量宫颈长度与剖宫产术后阴道分娩成功的相关性
Relationship between cervical length by ultrasonic measurement and successful vaginal birth after cesarean section
摘要
Abstract
Objective:To explore the influencing factors affecting vaginal birth after ce-sarean section ( VBAC) . Methods:114 cases of pregnant women willing to trial of labor after cesarean ( TOLAC) were concluded. The cervix length was measured by ultrasound examina-tion. These cases were divided into successful group and fail group according to whether suc-cessful VBAC finally. Single factor analysis and multivariable Logistic regression analysis about the influencing factors affecting VBAC were conducted. The relationship between cervical length and VBAC was observed emphatically. Results:Success rate of TOLAC was 46. 49%. Single factor analysis showed no significant difference between the successful group and fail group in age,amount of bleeding,gravidity and parity history,time from last cesarean,whether having en-tered stages of labor last time,gestational age of delivery,vaginal delivery history,etc(all P>0 . 05 ) . The rate of spontaneous parturition and labor analgesia were both higher in successful group than that of fail group (both P<0. 05),while the weight of neonates was lower in success-ful group(P<0. 05). Logistics analysis showed spontaneous parturition and cervix length were independent factors influencing VBAC. Spontaneous parturition was a protection factor for suc-cess of TOLAC(B=3. 014,P<0. 001,OR= 20. 372);while cervix length was a risk factor for success of TOLAC (B=-0. 091,P<0. 05,OR=0. 913). Average cervical length of successful group was (19. 86±11. 05)mm,significantly shorter than length of fail group[(28. 61±7. 75) mm](P<0. 01). For each reduction of 1 mm in the cervical length,the odds ratio for successful VBAC was 1 . 095 ( P<0 . 05 ) . Conclusions:Spontaneous parturition is favorable factors for suc-cess of TOLAC,and cervix length measured by ultrasound is an independent factor influencing success rate of TOLAC. Cervical length is shorter,the better for VBAC.关键词
宫颈长度/超声测量/剖宫产后阴道试产( TOLAC)/剖宫产术后阴道分娩( VBAC)/影响因素Key words
Cervical length/Ultrasonic measurement/Trial of labor after cesarean ( TOLAC)/Vaginal birth after cesarean section Success( VBAC)/Influencing factors分类
医药卫生引用本文复制引用
康苏娅,周丽屏..超声测量宫颈长度与剖宫产术后阴道分娩成功的相关性[J].现代妇产科进展,2016,25(9):676-679,4.基金项目
苏州市妇产疾病临床医学中心(No:SZZX201505) （No:SZZX201505）
