만삭 단태임신의 분만일 예측과 관련된 초음파 인자 = Ultrasonographic factors related with prediction of delivery day in term singleton pregnancy

국문 초록 (Abstract)

목적: 본격적인 분만 진통 시작 전에 자궁근육과 자궁경부는 생화학적, 형태적 변화를 겪게 된다. 초음파 검사를 통해 이러한 형태적 변화 양상을 관찰함으로 실제 분만일과 연관된 인자를 찾고, 나아가 분만일의 예측이 가능한 지 알아보고자 하였다. 연구 방법: 재태기간 36주가 지난 단태임신 산모 61명을 대상으로 자연 진통에 따른 질식 분만을 하기까지 매주 초음파 검사를 시행하여 자궁하절부의 두께, 자궁경부의 길이, 자궁경관선의 두께와 양수지수를 측정하여 분만까지 남은 날과의 상관관계를 분석하였다. 대상 산모중 태아 기형이나 양수의 이상, 자궁하절부에 자궁근종이나 하위 태반이 존재하는 경우는 제외하고 52명을 최종 분석대상으로 하였다. 결과: 재태기간에 따라 자궁하절부의 두께, 양수지수, 자궁경부의 길이는 점차 감소하는 경향을 보였지만 통계적 유의성은 없었다. 초음파로 측정한 4가지 분만 연관 요인 중에서 자궁경부 길이가 측정일로부터 분만까지 남은 날을 예측하는데 통계적인 유의성을 보였으며 다음과 같은 수식으로 나타낼 수 있었다. 측정일에서 분만까지 남은 일수=6.12+0.24×자궁경부길이 (㎜) (r=0.29, p<0.01) 결론: 재태기간 36주 이후의 단태임신 산모에서 자궁경부길이의 초음파 측정은 측정일로부터 분만일까지의 남은 일 수와 관련이 있었다.

다국어 초록 (Multilingual Abstract)

Objective: The aim of this study was to find out the relating factors with the actual delivery day in term singleton pregnancy. Methods: The 52 patients with singleton gestation were visited weekly and measured for their lower uterine segment (LUS) thickness, cervical length and cervical gland thickness by transvaginal ultrasonography and for amnionic fluid index (AFI) by transabdominal ultrasonography from 36 weeks of gestation until birth. Regression analysis was used to find out the relevance between these factors and remaining days to birth. Resullts: There was a significant relationship between cervical length and remaining days to birth in term pregnancy, which could be described as a mathematical equation (remaining days for delivery=6.12+0.24×cervical length (㎜) r=0.29, p<0.01). However, no relationship was found between factors such as LUS, AFI, and cervical gland thickness and remaining days to birth. Conclusion: Our results suggest that the actual delivery day in term singleton pregnancy might be predicted with cervical length.

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