Human Uterine Wall Tension Trajectories and the Onset of Parturition
Human Uterine Wall Tension Trajectories and the Onset of Parturition
复制标题
人类子宫壁张力轨迹和分娩开始
作者：
P. Sokolowski;Francis Saison;W. Giles;S. McGrath;David Smith;Julia Smith;Roger Smith
子宫壁张力被认为是孕妇分娩开始的重要决定因素。我们使用超声表征人类子宫壁张力从妊娠中期到分娩，并比较早产，足月妊娠和双胎妊娠。在2000-2004年期间，在澳大利亚新南威尔士州约翰亨特医院，共对320名孕妇进行了从首次产前检查到分娩的随访。通过连续超声测量子宫壁厚度、长度、前后径和横径。受试者被分为三组：单胎妊娠和自然分娩的妇女，无论是早产或足月和双胎妊娠的妇女。将文献中的子宫内压结果与我们的数据相结合，使用长椭圆体方法形成每个妇女的子宫壁厚度、体积和张力的轨迹，并在妊娠20周、25周和30周时对各组进行比较。子宫壁张力遵循指数曲线，结果在整个妊娠期随着前壁最大张力部位的增加而增加。早产儿子宫壁厚度较足月儿增加。与单胎妊娠相比，双胎妊娠的宫内容积增加（），但子宫壁厚度没有增加。没有证据表明早产或双胎妊娠的孕妇紧张情绪增加。这些数据与高子宫壁张力作为单胎或双胎妊娠中早产自然分娩的原因不一致。多胎妊娠中的激素差异似乎是导致这一组早产率增加的原因，而不是增加了紧张感。
Uterine wall tension is thought to be an important determinant of the onset of labor in pregnant women. We characterize human uterine wall tension using ultrasound from the second trimester of pregnancy until parturition and compare preterm, term and twin pregnancies. A total of 320 pregnant women were followed from first antenatal visit to delivery during the period 2000–2004 at the John Hunter Hospital, NSW, Australia. The uterine wall thickness, length, anterior-posterior diameter and transverse diameter were determined by serial ultrasounds. Subjects were divided into three groups: women with singleton pregnancies and spontaneous labor onset, either preterm or term and women with twin pregnancies. Intrauterine pressure results from the literature were combined with our data to form trajectories for uterine wall thickness, volume and tension for each woman using the prolate ellipsoid method and the groups were compared at 20, 25 and 30 weeks gestation. Uterine wall tension followed an exponential curve, with results increasing throughout pregnancy with the site of maximum tension on the anterior wall. For those delivering preterm, uterine wall thickness was increased compared with term. For twin pregnancies intrauterine volume was increased compared to singletons (), but wall thickness was not. There was no evidence for increased tension in those delivering preterm or those with twin gestations. These data are not consistent with a role for high uterine wall tension as a causal factor in preterm spontaneous labor in singleton or twin gestations. It seems likely that hormonal differences in multiple gestations are responsible for increased rates of preterm birth in this group rather than increased tension.