Benediktsdottir Sigurlaug, Salvesen Kjell Å, Hjartardottir Hulda, Eggebø Torbjørn M
Department of Obstetrics and Gynecology, Clinical Sciences, Lund University, Lund, Sweden.
Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland.
Acta Obstet Gynecol Scand. 2018 Jan;97(1):97-103. doi: 10.1111/aogs.13251. Epub 2017 Nov 23.
We aimed to test the reproducibility of head-perineum distance (HPD) measurements using two different ultrasound devices and five examiners, to compare ultrasound measurements and clinical assessments and to study if ultrasound examinations were acceptable for women in labor.
A reproducibility study was performed at Lund University Hospital, Sweden and Landspitali University Hospital, Iceland from February 2015 to February 2017. The study population comprised 40 healthy women in labor. HPD was measured with three replicate measurements from each woman with two different ultrasound devices, and the measurements were compared with clinical assessments. Acceptability was tested with a visual analog scale (VAS), and the mean VAS score from both ultrasound devices was compared with the VAS score from clinical palpation.
The median time interval between start of examinations with devices was 10 min (range 1-26 min). The intra-observer repeatability coefficient was 4.3 mm and the intraclass correlation coefficient was 0.97 (95% CI 0.95-0.98). The intraclass correlation coefficient between the two devices was 0.86 (95% CI 0.74-0.93) and limits of agreement were -9.6 mm to 16.6 mm. However, we observed a significant mean HPD difference between devices (3.5 mm; 95% CI 1.4-5.6 mm). Clinical assessments and the mean measurements of HPD were correlated (r = 0.64, p < 0.01). We found significant differences in acceptability in favor of ultrasound. The mean VAS score for both ultrasound devices was 2.0 vs. 4.1 for clinical examination (p < 0.01).
We found excellent intra-observer repeatability, good correlation but significant difference between devices. Women reported less discomfort with ultrasound than with clinical examinations.
我们旨在测试使用两种不同超声设备和五名检查者测量头-会阴距离（HPD）的可重复性，比较超声测量与临床评估，并研究超声检查对分娩期女性是否可接受。
2015年2月至2017年2月在瑞典隆德大学医院和冰岛国家大学医院进行了一项可重复性研究。研究人群包括40名健康的分娩期女性。使用两种不同超声设备对每位女性进行三次重复测量HPD，并将测量结果与临床评估进行比较。使用视觉模拟量表（VAS）测试可接受性，并将两种超声设备的平均VAS评分与临床触诊的VAS评分进行比较。
使用设备开始检查之间的中位时间间隔为10分钟（范围1-26分钟）。观察者内重复性系数为4.3毫米，组内相关系数为0.97（95%CI 0.95-0.98）。两种设备之间的组内相关系数为0.86（95%CI 0.74-0.93），一致性界限为-9.6毫米至16.6毫米。然而，我们观察到设备之间存在显著的平均HPD差异（3.5毫米；95%CI 1.4-5.6毫米）。临床评估与HPD的平均测量值相关（r = 0.64，p < 0.01）。我们发现超声检查在可接受性方面存在显著差异，支持超声检查。两种超声设备的平均VAS评分为2.0，而临床检查为4.1（p < 0.01）。
我们发现观察者内重复性极佳，相关性良好，但设备之间存在显著差异。女性报告超声检查比临床检查的不适感更少。
