El Khouly Nabih I, Elkelani Osama A, Saleh Said A
a Obstetrics and Gynecology Department , Faculty of Medicine, Menoufia University , Shibin Elkom , Egypt.
J Matern Fetal Neonatal Med. 2017 Aug;30(16):1948-1952. doi: 10.1080/14767058.2016.1233398. Epub 2016 Sep 22.
The purpose of this study was to assess the value of combining the estimated fetal weight (EFW) and amniotic fluid index (AFI) measured in term patients early in labor with intact membranes for prediction of macrosomia.
In a single center, prospective observational study, 600 patients in the first stage of labor before rupture of membranes in whom ultrasonography was performed to measure AFI and EFW, and these data were analyzed statistically to evaluate prediction of fetal macrosomia.
Macrosomia occurred in 64 cases (10.6%). The AFI was significantly higher in the macrosomic group (p = 0.001). It was noted that the area under receiver operating characteristic (ROC) curves for EFW was 0.93 and that of AFI was 0.67. Based on suggested combined EFW and AFI cutoffs of 4000 g and 164 mm, respectively, the positive predictive value (PPV) for combined parameters (92.3%) was higher than that of EFW (75%) and that of AFI (27%) and the likelihood ratio for combination (93.7%) was higher than that of EFW (24.7%) and that of AFI (21%).
Combined use of EFW and AFI improves prediction of macrosomia at birth rather than the EFW alone.
本研究旨在评估在胎膜完整的足月产妇分娩早期测量的估计胎儿体重（EFW）和羊水指数（AFI）相结合对巨大儿预测的价值。
在一项单中心前瞻性观察研究中，对600例胎膜未破的第一产程患者进行超声检查以测量AFI和EFW，并对这些数据进行统计学分析以评估胎儿巨大儿的预测情况。
64例（10.6%）发生巨大儿。巨大儿组的AFI显著更高（p = 0.001）。注意到EFW的受试者操作特征（ROC）曲线下面积为0.93，AFI的为0.67。基于分别建议的EFW和AFI临界值4000 g和164 mm，联合参数的阳性预测值（PPV）（92.3%）高于EFW（75%）和AFI（27%），联合的似然比（93.7%）高于EFW（24.7%）和AFI（21%）。
联合使用EFW和AFI可改善对出生时巨大儿的预测，而不仅仅是单独使用EFW。
