产时超声在产程监测中的应用

doi:10.12280/gjszjk.20240367

摘要/Abstract

摘要：

分娩过程中，准确评估胎方位、胎先露位置和宫颈扩张程度对于判断产程进展和选择分娩方式至关重要。然而，传统的阴道触诊可能带来不良的分娩体验和感染风险。近年来，产时超声因具有高准确性、良好的可重复性和较高的孕产妇依从性，逐渐成为产程监测的重要工具。其通过测量宫颈扩张（cervical dilatation，CD）、产程进展角（angle of progression，AOP）、胎头与会阴间距离（head-perineum distance，HPD）、胎头耻骨联合间距离（head-symphysis distance，HSD）、中线角（midline angle，MLA）、胎头方向（head direction，HD）、胎头下降距离（progression distance，PD）、枕骨脊柱角（occiput-spine angle，OSA）和下颌胸骨角（chin-chest angle，CCA）等关键参数，能够精确定位胎方位和胎头位置，有助于及时识别异常胎位，为是否需要借助吸引器或产钳来辅助分娩或者进行剖宫产提供了依据，从而改善分娩结局、降低并发症风险。尽管超声在产程监测中具有辅助作用，但其应用仍需更多临床数据支持以完善和提升。随着技术进步，产时超声有望更广泛地推广，提升分娩管理的专业性和安全性。

关键词: 胎产式, 试分娩, 产程, 第一, 产程, 第二, 产程, 第三, 产时超声, 分娩管理

Abstract:

Accurate assessment of fetal position, fetal presenting part, and cervical dilation during labor are critical for evaluating labor progression and determining the mode of delivery. However, traditional vaginal examination may lead to adverse birthing experiences and carry a risk of infection. In recent years, intrapartum ultrasound has emerged as an essential tool for labor monitoring due to its high accuracy, reproducibility, and better maternal compliance. By measuring the key parameters such as cervical dilatation (CD), angle of progression (AOP), head-perineum distance (HPD), head-symphysis distance (HSD), midline angle (MLA), head direction (HD), progression distance (PD), occiput-spine angle (OSA) and chin-chest angle (CCA), ultrasound enables precise determination of fetal position and fetal head location. Therefore, intrapartum ultrasound facilitates the timely identification of abnormal fetal positions and provides a guidance on whether interventions such as vacuum extraction, forceps-assisted delivery, or cesarean section are necessary, thereby improves delivery outcomes and reduces the risk of complications. Although ultrasound has demonstrated its auxiliary role in labor monitoring, further clinical data are needed so as to refine and enhance its application. With advancements in technology, intrapartum ultrasound is expected to become more widely adopted, and to enhance the professionalism and safety in labor management.

Key words: Labor presentation, Trial of labor, Labor stage, first, Labor stage, second, Labor stage, third, Intrapartum ultrasound, Labor management

孙璐鑫, 韩英杰. 产时超声在产程监测中的应用[J]. 国际生殖健康/计划生育杂志, 2025, 44(1): 84-88.

SUN Lu-xin, HAN Ying-jie. Application of Intrapartum Ultrasound in Labor Monitoring[J]. Journal of International Reproductive Health/Family Planning, 2025, 44(1): 84-88.

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