临床估计胎儿体重：专业经验能否提高准确性？

Clinical estimation of fetal weight: is accuracy acquired with professional experience?

机构信息

Gynecology Department, Lis Maternity Hospital, Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. ishai.levin @ gmail.com

出版信息

Fetal Diagn Ther. 2011;29(4):321-4. doi: 10.1159/000323149. Epub 2011 Jan 21.

DOI:10.1159/000323149

PMID:21252483

Abstract

OBJECTIVE

This study was conducted in order to determine whether experience and type of obstetrical profession improves the accuracy in the clinical estimation of fetal weight among obstetricians and midwives in the delivery room.

METHODS

Four groups of professionals in the delivery room clinically estimated the fetal weight in 236 parturients in active labor. Obstetric parameters such as gravidity, parity, gestational age, body mass index, amniotomy, station and cervical dilatation were recorded. Fetal weight estimations were compared with the actual birth weight after delivery.

RESULTS

The mean error rate of fetal weight estimation by attending obstetricians, residents, experienced and junior midwives was 7.9 ± 8.8, 8.0 ± 8.4, 7.8 ± 6.3 and 8.5 ± 6.8%, respectively. Error rates of the 4 groups of examiners were similar, although it was increased in all subgroups when estimating birth weights <2,500 and >4,000 g. Major discrepancies of fetal weight estimation (>10% of the actual fetal birth weight) occurred in 27.2, 28.9, 31.9 and 34.7% by attending obstetricians, residents, experienced and junior midwives, respectively.

CONCLUSIONS

We found no additional value for experience and type of obstetrical training in the accuracy of clinical fetal weight estimation.

摘要

目的

本研究旨在确定产科医生和助产士在分娩室中临床估计胎儿体重的准确性是否会因经验和产科专业类型而有所提高。

方法

在 236 名活跃产妇中，4 组分娩室专业人员对胎儿体重进行了临床估计。记录了产科参数，如孕次、产次、孕周、体重指数、破膜、胎先露和宫颈扩张程度。将胎儿体重估计值与分娩后的实际出生体重进行比较。

结果

主治医生、住院医生、有经验的和初级助产士估计胎儿体重的平均误差率分别为 7.9±8.8%、8.0±8.4%、7.8±6.3%和 8.5±6.8%。虽然当估计出生体重<2500 克和>4000 克时，所有亚组的误差率都有所增加，但 4 组检查者的误差率相似。胎儿体重估计的重大差异（>实际胎儿出生体重的 10%）分别发生在主治医生、住院医生、有经验的和初级助产士中，占 27.2%、28.9%、31.9%和 34.7%。