足月单胎初产妇引产失败的预测因素研究  

Predictive factor of failure to induce labor in full-term singleton nulliparous women

作　　者：王丽娜 张昀[1] 陈钰[2] 冯钰 吴夏迪 Wang Lina;Zhang Yun;Chen Yu(Department of Premarital and Prenatal Health Care,Wuxi Maternity and Child Health Care Hospital,Wuxi 214002;Department of Obstetrics,Wuxi Maternity and Child Health Care Hospital,Wuxi 214002)

机构地区：[1]无锡市妇幼保健院婚前孕前保健科,无锡214002 [2]无锡市妇幼保健院产科,无锡214002 [3]无锡市妇幼保健院妇女保健科,无锡214002

出　　处：《现代妇产科进展》2025年第1期38-41,共4页Progress in Obstetrics and Gynecology

基　　金：无锡市卫生健康委员会科研重大项目(No:Z202301);无锡市市妇幼健康科研项目(No:FYKY202101)。

摘　　要：目的:探讨足月单胎初产妇引产失败的临床指标和超声参数的影响因素并建立引产失败的预测模型。方法:回顾分析2021年1月1日至2021年6月30日于无锡市妇幼保健住院分娩的300例产妇,其中引产成功组200例,失败组100例。结果:两组产妇的年龄、产前体重、产前孕周、引产指征、引产方式比较,差异无统计学意义(P>0.05)。引产成功组的平均身高高于失败组,产前BMI低于失败组,宫高+腹围值小于失败组(P<0.05),两组产妇宫颈Bishop≤3分占比差异有统计学意义(P<0.05)。引产成功组胎儿的双顶径+股骨长、腹围、头围及胎儿估重均小于引产失败组(P<0.05)。多因素logistic回归分析显示,初产妇的身高是引产失败的保护性因素(OR=0.82,P<0.05),产前BMI、胎儿估重≥3750g、Bishop评分≤3分是引产失败的危险因素(OR=1.15、9.41、2.51,P<0.05)。构建引产失败的预测模型,ROC曲线下面积(AUC)为0.86(95%CI为0.81~0.90),约登指数为0.58,敏感度为87%,特异度为71%,预测准确率为81%,Hosmer-Lemeshow检验P=0.10。结论:本研究成功筛选出初产妇引产失败的4个显著影响因素,同时构建了引产失败的预测模型。为提升引产成功率提供了坚实的理论依据,有力保障了母儿的安全。Objective:To explore the clinical factors and ultrasound parameters of failed induction of labor in full-term singleton nulliparous women,and to establish a prediction model for failed induction of labor.Methods:The retrospective analysis included a total of 300 pregnant women who gave birth at the Wuxi Maternal and Child Health Care Hospital from January 12021 to June 302021.There were 200 cases in successful induced labor group and 100 cases in failure group.Results:There was no significant difference in age,prenatal weight,gestational age,indication for inducing labor and methods of induced labor between the two groups.The height of women in the successful labor induction group was greater than the height of women in the failed labor induction group,the prenatal BMI was lower than the failed group,and the uterine height+abdominal circumference was lower than the failed group(P<0.05).The proportion of cervical Bishop≤3 points was different between the two groups(P<0.05).The biparietal diameter+femur length,abdominal circumference,head circumference and estimated fetal weight in the successful labor induction group were all lower than those in the failed labor induction group(P<0.05).Multivariate logistic regression analysis showed that maternal mean stature was the protective factor for failed labor induction(OR=0.82,P<0.05),estimated fetal weight≥3750g,Bishop score≤3 points were the risk factors for failed labor induction(OR=1.15,9.41,2.51,P<0.05).The area under the ROC curve(AUC)of the prediction model of failed labor induction was 0.86(95%CI 0.81~0.90),the Youden index was 0.58,the sensitivity was 87%,the specificity was 71%,the prediction accuracy was 81%,and the Hosmer-Lemeshow test was P=0.10.Conclusion:This study successfully screened out four significant influencing factors for the failed induction of labor among primiparas and constructed a prediction model for failed induction of labor,providing a solid theoretical basis to improve the success rate of induction of labor and strongly ensure the s

关 键 词：引产失败 初产妇 影响因素 预测模型 

分 类 号：R714.7[医药卫生—妇产科学]