在第三阶段的劳动使用剪切波弹性图形评估子宫收缩和动出血
Ayumi Okuyama1,2, Junichi Hasegawa2,3, Kohei Seo1,2
1Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama 224-8503, Japan.
Diagnostics (Basel, Switzerland)
|July 27, 2024
概括
在分娩的第三阶段,通过剪波弹性学测量下子宫硬度,与分娩后血流增加有关. 这表明子宫收缩会影响血液静止,基线刚度较弱,胎盘分离时间较长,与大量出血有关.
科学领域:
- 产科和妇科 产科和妇科
- 医学超声波 医学超声波
- 生物物理学的生物物理.
背景情况:
- 产后出血仍然是孕产妇死亡的主要原因之一.
- 在分娩的第三阶段对子宫血静的准确评估对于防止过度流血至关重要.
- 剪波弹性图 (SWE) 提供了一种非侵入性方法来量化组织硬度,包括子宫肌肉.
研究的目的:
- 为了研究由SWE评估的子宫硬性和分娩后血液流失在分娩的第三阶段之间的关系.
- 为了确定子宫硬性的客观测量是否可以预测产后显著出血.
主要方法:
- 一项前性队列研究,涉及到到期的单子妊娠 (妊娠≥37周).
- 在第三阶段的分娩过程中,基于SWE的连续横腹超声波测量子宫硬度.
- 大 (≥500克) 和小血损失的妇女之间的SWE值的比较.
主要成果:
- 与血液流失小 (0.97 m/s对比1.25 m/s,p=0.02) 的女性相比,患有大量分娩后流血的女性表现出明显较低的最小中位切割波速度 (SWV) 值.
- 两组之间没有发现平均值,中位数或最大SWV的显著差异.
- 婴儿分娩和胎盘分娩之间的间隔在大量失血组中明显较长 (370.5秒对274秒,p<0.05).
结论:
- 使用SWE的超声波量化子宫硬性可以提供有关分娩第三阶段子宫血静的见解.
- 降低基线子宫硬度和延长胎盘分离时间可能与明显产后出血风险的增加有关.
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