Thurnau G R, Morgan M A
Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City 73190.
Am J Obstet Gynecol. 1988 Nov;159(5):1168-72. doi: 10.1016/0002-9378(88)90438-3.
The fetal-pelvic index, which compares fetal head and abdomen circumferences with respective maternal inlet and midpelvic circumferences, was introduced in 1986 as a means of identifying the presence or absence of fetal-pelvic disproportion. In this study the efficacy of the fetal-pelvic index was evaluated in 46 patients with abnormal labor patterns that required labor augmentations and was compared with that of two other means (Colcher-Sussman x-ray pelvimetry and ultrasonographically derived estimated fetal weight greater than or equal to 4000 gm). Of the 24 women who required operative intervention (19 cesarean sections and five operative vaginal procedures), 17 had positive fetal-pelvic index values (sensitivity = 0.71). Six of the seven fetuses of patients with false-negative fetal-pelvic index values persisted in an occipitoposterior presentation, and these patients failed to progress in labor. Of the 22 patients in whom vaginal deliveries were spontaneous, 21 had negative fetal-pelvic index values (specificity = 0.95). Of the 18 women with positive fetal-pelvic index values, 17 required operative intervention (positive predictability = 0.94). In contrast, when used alone, neither x-ray pelvimetry nor ultrasonographically derived estimated fetal weight greater than or equal to 4000 gm provided accurate identification of fetal-pelvic disproportion.
胎儿骨盆指数于1986年被引入，用于比较胎儿头围和腹围与相应母体骨盆入口和中骨盆周长，以此来判断胎儿与骨盆是否不相称。在本研究中，对46例产程异常需加强宫缩的患者评估了胎儿骨盆指数的有效性，并与其他两种方法（科尔彻 - 苏斯曼X线骨盆测量法和超声推算胎儿体重≥4000克）进行比较。在24例需要手术干预的产妇中（19例行剖宫产，5例行阴道助产手术），17例胎儿骨盆指数为阳性（敏感性 = 0.71）。胎儿骨盆指数为假阴性的患者中，7例胎儿中有6例持续枕后位，这些患者产程无进展。在22例自然阴道分娩的患者中，21例胎儿骨盆指数为阴性（特异性 = 0.95）。胎儿骨盆指数为阳性的18例产妇中，17例需要手术干预（阳性预测值 = 0.94）。相比之下，单独使用X线骨盆测量法或超声推算胎儿体重≥4000克，均不能准确判断胎儿与骨盆是否不相称。
