Abstract：
The assessment of labor progress from digital vaginal examination has remained largely unchanged for at least a century, despite the current major advances in maternal and perinatal care. Although inconsistently reproducible, the findings from digital vaginal examination are customarily plotted manually on a partogram, which is composed of a graphical representation of labor, together with maternal and fetal observations. The partogram has been developed to aid recognition of failure to labor progress and guide management-specific obstetrical intervention. In the last decade, the use of ultrasound in the delivery room has increased with the advent of more powerful, portable ultrasound machines that have become more readily available for use. Although ultrasound in intrapartum practice is predominantly used for acute management, an ultrasound-based partogram, a sonopartogram, might represent an objective tool for the graphical representation of labor. Demonstrating greater accuracy for fetal head position and more objectivity in the assessment of fetal head station, it could be considered complementary to traditional clinical assessment. The development of the sonopartogram concept would require further undertaking of serial measurements. Advocates of ultrasound will concede that its use has yet to demonstrate a difference in obstetrical and neonatal morbidity in the context of the management of labor and delivery. Taking a step beyond the descriptive graphical representation of labor progress is the question of whether a specific combination of clinical and demographic parameters might be used to inform knowledge of labor outcomes. Intrapartum cesarean deliveries and deliveries assisted by forceps and vacuum are all associated with a heightened risk of maternal and perinatal adverse outcomes. Although these outcomes cannot be precisely predicted, many known risk factors exist. Malposition and high station of the fetal head, short maternal stature, and other factors, such as caput succedaneum, are all implicated in operative delivery; however, the contribution of individual parameters based on clinical and ultrasound assessments has not been quantified. Individualized risk prediction models, including maternal characteristics and ultrasound findings, are increasingly used in women\'s health-for example, in preeclampsia or trisomy screening. Similarly, intrapartum cesarean delivery models have been developed with good prognostic ability in specifically selected populations. For intrapartum ultrasound to be of prognostic value, robust, externally validated prediction models for labor outcome would inform delivery management and allow shared decision-making with parents.
摘要：
至少一个世纪以来，数字阴道检查对分娩进展的评估基本保持不变，尽管目前孕产妇和围产期保健取得了重大进展。虽然重现性不一致，数字阴道检查的结果通常手动绘制在切片上，它由劳动的图形表示组成，连同母亲和胎儿的观察。已开发了分类图，以帮助识别分娩进展失败并指导针对特定管理的产科干预。在过去的十年里，超声在产房的使用随着功能更强大的出现而增加，便携式超声机已经变得更容易使用。尽管产时超声检查主要用于急性治疗，基于超声波的模式,声像图，可能代表了劳动力图形表示的客观工具。证明胎头位置更准确，胎头站评估更客观，它可以被认为是对传统临床评估的补充.声像图概念的发展将需要进一步进行连续测量。超声的拥护者将承认，在分娩和分娩管理的背景下，超声的使用尚未证明产科和新生儿发病率的差异。超越劳动力进展的描述性图形表示的步骤是是否可以使用临床和人口统计学参数的特定组合来告知劳动力结果的知识的问题。产时剖宫产分娩和产钳和真空辅助分娩都与孕产妇和围产期不良结局的风险增加有关。虽然这些结果无法准确预测，存在许多已知的危险因素。胎头错位和高位，产妇身材矮小，和其他因素，比如caputsucedaneum，都与手术分娩有关；然而，基于临床和超声评估的个体参数的贡献尚未量化.个性化风险预测模型，包括产妇特征和超声检查结果，越来越多地用于女性健康，例如，在先兆子痫或三体筛查中。同样，在特定选择的人群中，已开发出具有良好预后能力的产时剖宫产模型。为了使产时超声具有预后价值，健壮,外部验证的分娩结果预测模型将为分娩管理提供信息，并允许与父母共享决策。
