日本医科大学雑誌
Online ISSN : 1884-0108
Print ISSN : 0048-0444
ISSN-L : 0048-0444
頚管成熟度と分娩との関係について
田村 元良
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ジャーナル フリー

1982 年 49 巻 4 号 p. 519-531

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Cervical ripening score in three factors of consistency, length and dilatation has been evaluated by bimanual examination, and furthermore, factors of fetal and cervical positions have been also taken into consideration as are in Bishop's pelvic score.
The following results have been obtained.
1) The error rate of measurement is about 10% and is not affected by parity and the elapse of time.
2) Both in a primiparous and a multiparous patient, the cervix is ripened towards the end of the pregnancy, and the improvement is especially pronounced from the 8th to the 9th gestational month.
3) The cervical ripening score in primiparae just before the onset of labor has the coefficient correlation with the duration of the 1st stage of labor (r=-0. 23*), (1st and 2nd) stage: (-0.33**), interval between onset of labor and onset of fetal descent (-0.30**), but an insignificant relation is found in multiparae (**...significant on 1% level, *...significant, 5% level).
4) As for the score of the fetal descent, that is, the fetal position before labor, significant relation is found in multiparous patients, --such as with the duration of the 1st stage of labor, (r=-0.33**), (1st and 2nd) stage: (-0.26*), interval between onset of labor and onset (of fetal descent: (-0.24*), but no significance is obtained in primiparae.
5) Bishop's pelvic score has a significant relations with the duration of the 1st stage of labor (r=-0.28**) in primiparae, but no in multiparae.
6) The cervical ripening score directly before onset of labor has no significant relation to the incidence of a vacuum extraction delivery and fetal distress. Bleeding amount during labor increases in primiparae when the cervix is unripe, but not in multiparae.
Conclusion:
The cervical ripeness score is connected with the prediction of the labor process in primiparae, that is, the stages of labor are shortened when the cervix is ripe, while the position of fetal part before labor is connected with the prognosis in multiparae.
Therefore, in the cervical ripening scoring system, fetal element and cervical one should be separately considered.

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