KHẢO SÁT TỶ LỆ SANH NGẢ ÂM ĐẠO Ở SẢN PHỤ VỚI GÓC CỔ THÂN TỬ CUNG TỪ 90 ĐỘ KẾT HỢP CHỈ SỐ BISHOP TỪ 4 ĐIỂM VÀ CÁC YẾU TỐ LIÊN QUAN TẠI BỆNH VIỆN HÙNG VƯƠNG

Abstract

Objective: The objective of this study was to determine the rate of vaginal birth in pregnant women with uterocervical angle from 90 degrees combined with bishop score from 4 points and related factors at Hung Vuong hospital. Method: A prospective longitudinal study involving 335 cases of normal full term singleton pregnancies, cephalic presentation without previous incisions on the uterus and not contraindicated for vaginal delivery, was analyzed. Results: The rate of successful vaginal delivery in parturients with a cervical angle of 90 degrees combined with a Bishop score of 4 points was 87.2%. Factors associated with successful vaginal delivery after multivariate regression analysis were as follows: Multiparity had a higher likelihood of successful vaginal delivery with OR = 11.143; 95% CI [2.536 – 48.960]; p = 0.001. Fetal station of -2 had a higher likelihood of successful vaginal delivery compared to -3 with OR = 3.564; 95% CI [1.458 – 8.715]; p = 0.005. No oxytocin augmentation when the cervical conditions were unfavorable had a higher likelihood of successful vaginal delivery compared to oxytocin augmentation with OR = 2.605; 95% CI [1.108 – 6.129]; p = 0.028. A larger cervical angle was associated with a higher likelihood of successful vaginal delivery with OR = 1.205; 95% CI [1.131 – 1.283]; p < 0.001. Early rupture of membranes reduced the likelihood of successful vaginal delivery, OR = 0.292; 95% CI [0.118 – 0.723]; p = 0.008. Conclusion: a uterocervical angle from 90 degrees combined with a Bishop score from 4 points may be an effective indicator for predicting successful vaginal delivery.