超声估测胎儿体质量的准确性、一致性及其对胎儿分娩方式的影响  

Accuracy and Consistency of Ultrasonic Estimation of Fetal Body Weight and Its Influence on Fetal Delivery Mode

作　　者：胡涌波 王海霞 施凤莲 HU Yongbo;WANG Haixia;SHI Fenglian(Department of Ultrasound,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou Henan 450000,China;Department of Ultrasound,Shanghai Tongkang Hospital,Shanghai 200000,China;Department of Obstetrics and Gynecology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou Henan 450000,China)

机构地区：[1]郑州大学附属郑州中心医院超声科,郑州450000 [2]上海同康医院超声科,上海200000 [3]郑州大学附属郑州中心医院妇产科,郑州450000

出　　处：《河南医学高等专科学校学报》2024年第5期585-589,共5页Journal of Henan Medical College

摘　　要：目的探讨超声估测胎儿体质量的准确性、一致性及其对胎儿分娩方式选择的影响。方法选取妊娠满28周且在本院住院分娩的单活胎妊娠初产妇1258例,记录胎儿实际体质量,采用三维容积超声测量部分肢体体积上臂中段50%的体积(AVol)和大腿中段50%的体积(TVol)评估胎儿体质量,比较不同年份胎儿实际体质量、超声AVol评估胎儿体质量、超声TVol评估胎儿体质量、分娩方式,以及不同分娩方式胎儿实际体质量、超声AVol评估胎儿体质量、超声TVol评估胎儿体质量,并分析胎儿实际体质量与超声AVol评估胎儿体质量、超声TVol评估胎儿体质量的相关性,以及超声AVol与超声TVol评估胎儿体质量的准确性、Kappa一致性。结果常规二维评估胎儿体重量与实际胎儿体质量、超声AVol评估胎儿体质量、超声TVol评估胎儿体质量比较,差异有统计学意义(P<0.05)。不同年份胎儿实际体质量、常规二维评估胎儿体质量、超声AVol评估胎儿体质量、超声TVol评估胎儿体质量比较,差异均无统计学意义(P>0.05)。不同年份胎儿剖宫产率比较,差异均无统计学意义(P>0.05)。剖宫产胎儿实际体质量、常规二维评估胎儿体质量、超声AVol评估胎儿体质量、超声TVol评估胎儿体质量高于顺产胎儿,差异有统计学意义(P<0.05)。经Pearson分析,实际体质量与超声AVol评估胎儿体质量、超声TVol评估胎儿体质量呈正相关(r=0.979、0.974,P<0.05)。超声AVol评估胎儿体质量的准确率为85.85%,超声TVol评估胎儿体质量的准确率为85.61%;超声AVol与超声TVol评估胎儿体质量的Kappa一致性为0.834。结论超声AVol、TVol评估胎儿体质量具有较高的准确性和一致性,控制胎儿体质量,有利于降低剖宫产率。Objective To explore the accuracy and consistency of ultrasonic estimation of fetal body weight and its influence on the selection of fetal delivery mode.Methods A total of 1258 primiparas with singleton live pregnancy who were hospitalized and gave birth in our hospital and had a gestational age of at least 28 weeks were selected.The actual body weight of the fetus was recorded.Three-dimensional volume ultrasound was used to measure the volume of 50%of the middle segment of the upper arm(AVol)and the volume of 50%of the middle segment of the thigh(TVol)of some limb volumes to evaluate the fetal body weight.The actual fetal body weight,fetal body weight evaluated by ultrasonic AVol,fetal body weight evaluated by ultrasonic TVol,and delivery mode in different years were compared.The actual fetal body weight,fetal body weight evaluated by ultrasonic AVol,and fetal body weight evaluated by ultrasonic TVol in different delivery modes were also compared.The correlation between the actual fetal body weight and the fetal body weight evaluated by ultrasonic AVol and ultrasonic TVol was analyzed.The accuracy and Kappa consistency of fetal body weight evaluated by ultrasonic AVol and ultrasonic TVol were also analyzed.Results There were statistically significant differences between the fetal body weight evaluated by conventional two-dimensional ultrasound and the actual fetal body weight,fetal body weight evaluated by ultrasonic AVol,and fetal body weight evaluated by ultrasonic TVol(P<0.05).There were no statistically significant differences in the actual fetal body weight,fetal body weight evaluated by conventional two-dimensional ultrasound,fetal body weight evaluated by ultrasonic AVol,and fetal body weight evaluated by ultrasonic TVol in different years(P>0.05).There was no statistically significant difference in the cesarean section rate of fetuses in different years(P>0.05).The actual fetal body weight,fetal body weight evaluated by conventional two-dimensional ultrasound,fetal body weight evaluated by ultrasonic AV

关 键 词：三维容积超声 胎儿体质量 分娩方式 剖宫产 

分 类 号：R445.12[医药卫生—影像医学与核医学]