Application Of Ultrasound-based Assessment In The First Stage Of Labor

Objective:To compare ultrasound assessments and clinical assessments in the first stage of labor,including fetal position、cervical dilatation and fetal head station.Methods:The fetal position,the size of cervical dilatation and fetal head station in the first stage of labor were monitored by ultrasound and clinical examination respectively almost at the same time.Ultrasound was used to measure the outer margin of the fetal head to the perineum distance(head-perineum distance,HPD)in sagittal and transverse views,and the angle of progression(AOP)was measured in sagittal views.The results were analyzed statistically.Results:In the monitoring of fetal position,the overall compliance rate of clinical fingering and ultrasonic monitoring was 39.5%,16%at the latent stage,58%at the active stage arid 62.5%at full cervical dilatation stage.For the monitoring of cervical dilatation size,the overall sample correlation coefficient r =0.85(P<0.01),the latency correlation coefficient r =0.26(p=0.035)at the active correlation coefficient r=0.75(p<0.01).The average number of cervical dilatation samples in clinical examination was 5.16cm with a standard deviation of s=2.94cm,while the ultrasound-based group was 6.31cm with a standard deviation 1.91cm.The overall mean difference between the two was (?)=-1.15cm(p<0.05),(?) =-2.24cm(p<0.05)at the latent stage and (?) =-0.26cm(p<0.12)at the active stage.The mean cervical dilatation was 8.8cm when clinical examination showed full dilatation.In the monitoring of fetal head station,the overall correlation coefficients between HPD and clinical digital samples was r =0.75(P<0.01),latency correlation coefficients r=0.37(p<0.01)and active correlation coefficients r =0.71(p<0.01).The correlation coefficients r =0.46(p<0.01)above the horizontal of the sciatic spines and the correlation coefficients r =0.44(p<0.01)at and below the horizontal of the sciatic spines.After removing the tumorigenesis and the cases of anterior amniotic sac protrusion,the coefficients was r =0.77(P<0.01).The overall correlation coefficients between AOP and clinical fingering samples was r =0..69(P<0.01),The correlation coefficients of latency r =0.32(p<0.01)and the correlation coefficients of active stage r =0.66(p<0.01),The correlation coefficients.r =0.35(p<0.01)above the horizontal of the sciatic spines and the correlation coefficients r =0.45(p<0.01)at and below the horizontal of the sciatic spines;After removing the tumorigenesis and the cases of anterior amniotic sac protrusion,the overall correlation coefficients of two methods was r =0.70(P<0.01).The overall correlation coefficients between AOP and HPD was r =-0.73(P<0.01),The correlation coefficients of latency r =-0.375(p<0.01)and the correlation coefficients of active stage r =-0.755(p<0.01);The correlation coefficients r =-0.47(p<0.01)above the horizontal of the sciatic spines and the correlation coefficients r =-0.65(p<0.01)at and below the horizontal of the sciatic spines;After removing the tumorigenesis and the cases of anterior amniotic sac protrusion,the overall correlation coefficients of two methods was r =-0.75(P<0.01).The mean value of HPD:The mean difference of two methods was (?) =-0.06cm(p=0.004),the mean of latency difference was (?) =-0.02cm(p=0.56)and the mean of active difference was (?) =-0.09em(p=0.001);the mean difference above the horizontal of the sciatic spines was (?) =-0.06cm(p=0.02)and (?) =-0.06cm(p=0.09)at and below the horizontal of the sciatic spines.Conclusions:There was a low coincidence rate in fetal position monitoring.There was a significant correlation between the two in the monitoring of cervical dilatation size.There was a significant correlation between AOP and HPD and clinical fingerprinting in terms of fetal head station.There was no significant difference between the two views of HPD at the latent stage,and there was a significant difference at the active stage between the two groups.There was a significant difference above the horizontal of the sciatic spines,and there was no significant difference at and below the the horizontal of the sciatic spines.