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Please use this identifier to cite or link to this item: http://hdl.handle.net/10285/97

NII Resource type: Departmental Bulletin Paper
Title: 新案のScoring Systemを用いた臨床的研究
Other Titles: A Clinical Approach to Evaluate Prelabor Status. A New Scoring System.
Authors: 神津, 弘
Shimei: 聖路加看護大学紀要
Issue: 4
Start page: 12
End page: 28
Issue Date: 1-Apr-1977
ISSN: 02892863
Abstract-Alternative: To evaluate the prelabor status by pelvic examination, besides the position and consistency of the portio, cervical effacement, dilatation, and height of the presenting part (station) as in previous scoring systems, the rigidity of the internal os of the cervix and accommodation of feto-pelvic axis (A.F.P.A.) were added. Scores were graded as 0, 1, 2, and 3 in every item. A total of 269 cases (169 nulliparas, 100 multiparas.) were studied retrospectively, from 36 weeks 0 day to 43 weeks 3 days of gestation, who were eventually delivered on occipito anterior presentation. The scores were checked for each prenatal visit once a week, the last pelvic scoring was made when their pregnancies had progressed to within 7 days of term. The correlation between the final total scores and the date of labor onset were analysed statistically. Total score gradually increased as the end of pregnancy approached, suggesting that this scoring system was useful to estimate the spontaneous onset of labor, especially in those whose onset of labor was within 5 days after final examination. The following results were obtained:(1) When the pelvic score totaled 14 or more, the labor onset occurred within 48 hours in 70% of nulliparous and 74.3% of multiparous women. On the other hand, when the score was 10 or less, in 90% of nulliparas and 100% multiparas the onset was not observed within the same period.(2) A.F.P.A. and effacement were not related to the parity, but in nulliparous patients the station of presenting part, and in the multipara the portio consistency, effacement and rigidity of the cervix were advanced more, compared with A.F.P.A. development.(3) Development of the mean score in each item was shown as follows: (I) A.F.P.A. Developed at the same space with station and position of portio in all cases, but was not related to cervical dilatation in the nullipara. (ii) The rigidity of the internal os became mild when labor onset approached. This tendency paralleled the portio consistency and cervical effacement in the nullipara, but in the multipara there two factors developed earlier. (iii) In multiparous women cervical dilatation precede effacement in many cases;conversely the latter preceded the former in the nullipara.
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URI: http://hdl.handle.net/10285/97
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