Awonuga Awoniyi O, Merhi Zaher, Awonuga Modupe T, Samuels Terri-Ann, Waller Jennifer, Pring David
Division of Benign Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Medical College of Georgia, Suite BB7513, Augusta, GA 30912-3345, USA.
Arch Gynecol Obstet. 2007 Nov;276(5):523-8. doi: 10.1007/s00404-007-0370-0. Epub 2007 Apr 26.
To determine whether measurements of maternal height and shoe size are predictors of pelvic size, using erect lateral computerized tomography (CT) pelvimetry as gold standard.
Three hundred and fifty three obstetric patients out of a sequential population of 6112 (5.8%) had CT pelvimetry performed between January 1990 and December 1991 at the Department of Obstetrics and Gynecology, York District Hospital, United Kingdom. Multivariable logistic regression models were built using maternal height (n = 322), shoe size (314) and weight at last clinic visit (n = 318). The reference standard for pelvic size was CT Pelvimetry. Pelvic adequacy was defined as an anterior-posterior diameter of the inlet of > or =11 cm and an anterior-posterior diameter of the outlet > or =10 cm on erect lateral CT pelvimetry. Women with values lower than these were regarded as having an inadequate pelvis. The diagnostic accuracy of the models was determined by the area under the receiver operating characteristic curve (AUC).
The area under the curve (AUC) for maternal height (0.768) was not significantly greater than that for shoe size (0.686, p = 0.163 for the difference in AUC's) and weight at the last clinic visit (0.655, p = 0.057 for the difference in the AUCs). The change in the AUC for each of the models (the full model with height, shoe size and weight [0.769]; model for height and shoe size [0.767] model for just height [0.768]) was also not significantly different.
Measurements of maternal height, shoe size and weight at the last clinic visit are not useful for the identification of women with inadequate pelvis.
以直立位侧位计算机断层扫描(CT)骨盆测量作为金标准,确定孕妇身高和鞋码测量值是否为骨盆大小的预测指标。
1990年1月至1991年12月期间,在英国约克区医院妇产科,对连续6112例产妇中的353例(5.8%)进行了CT骨盆测量。使用孕妇身高(n = 322)、鞋码(314)和上次门诊就诊时的体重(n = 318)建立多变量逻辑回归模型。骨盆大小的参考标准为CT骨盆测量。骨盆充足定义为直立位侧位CT骨盆测量时入口前后径≥11 cm且出口前后径≥10 cm。低于这些值的女性被视为骨盆不足。模型的诊断准确性通过受试者操作特征曲线(AUC)下的面积来确定。
孕妇身高的曲线下面积(AUC)(0.768)并不显著大于鞋码的曲线下面积(0.686,AUC差异的p = 0.163)和上次门诊就诊时体重的曲线下面积(0.655,AUC差异的p = 0.057)。每个模型的AUC变化(包含身高、鞋码和体重的完整模型[0.769];身高和鞋码模型[0.767];仅身高模型[0.768])也无显著差异。
孕妇身高、鞋码和上次门诊就诊时的体重测量值对识别骨盆不足的女性并无帮助。