在尼日利亚西南部一家志愿机构医院监测的足月分娩产妇中，临床方法估计胎儿体重和预测分娩方式的可靠性。

Reliability of a clinical method in estimating foetal weight and predicting route of delivery in term parturient monitored at a voluntary agency hospital in Southwest Nigeria.

机构信息

Olikoye Ransome Kuti Memorial Hospital, Asero, Abeokuta, Ogun State, Nigeria; and, General Hospital Owode-Egba, Owode, Ogun State, Nigeria; and, Department of Family Medicine, National Postgraduate Medical College of Nigeria, Ijanikin, Lagos, Nigeria; and, Department of Family Medicine, Mercy Groups Clinics, Panseke, Abeokuta, Ogun State.

出版信息

Afr J Prim Health Care Fam Med. 2021 Sep 8;13(1):e1-e6. doi: 10.4102/phcfm.v13i1.3017.

DOI:10.4102/phcfm.v13i1.3017

PMID:34636604

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8517749/

Abstract

BACKGROUND

The antepartum estimation of foetal weight is a major determinant of the route of delivery and this has become vital in modern day obstetrics. The limitations to the use of obstetric ultrasonography, considered as the gold standard in estimating foetal weight, make clinical estimation methods attractive alternatives, especially in resource- constrained settings where many un-booked women may report for delivery.

AIM

To determine the reliability of intrapartum clinical foetal weight estimation in predicting the actual birth weight (ABW) and route of delivery among term parturient.

SETTING

The study was conducted at the Sacred Heart Hospital, Lantoro, a voluntary mission agency hospital in Southwest Nigeria.

METHODS

This cross-sectional study was conducted among 291 term parturient recruited by systematic random sampling between June and September 2017. The clinical estimation of foetal weight was carried out using Johnson's formula.

RESULTS

The accuracy of Johnson's formula to predict the ABW was 59.5%; while for the mode of delivery, it was 130 (75.1%) for spontaneous vaginal delivery (SVD) and 43 (24.9%) for caesarean section (CS). The sensitivity of the accuracy of Johnson's formula to predict the mode of delivery was 75.1%, with a specificity of 35.6%, a positive predictive value (PPV) of 63.1%, and a negative predictive value (NPV) of 49.4%.

CONCLUSION

The intrapartum clinical foetal weight estimation at term determined by Johnson's formula was reliably predictive of ABW and SVD, but it was unreliable in predicting the need for a CS.

摘要

背景

产前胎儿体重估算是决定分娩方式的主要因素，这在现代产科中至关重要。由于产科超声检查存在局限性，被认为是估计胎儿体重的金标准，因此临床估计方法成为有吸引力的替代方法，尤其是在资源有限的环境中，许多未预约的妇女可能会来分娩。

目的

确定产时临床胎儿体重估测在预测足月分娩产妇实际出生体重（ABW）和分娩方式中的可靠性。

设置

本研究在尼日利亚西南部的一个志愿使命机构医院——兰托罗的圣心医院进行。

方法

本横断面研究于 2017 年 6 月至 9 月期间通过系统随机抽样，对 291 名足月分娩产妇进行了研究。使用 Johnson 公式进行胎儿体重的临床估计。

结果

Johnson 公式预测 ABW 的准确性为 59.5%；而对于分娩方式，自然阴道分娩（SVD）为 130 例（75.1%），剖宫产（CS）为 43 例（24.9%）。Johnson 公式预测分娩方式的准确性的敏感度为 75.1%，特异度为 35.6%，阳性预测值（PPV）为 63.1%，阴性预测值（NPV）为 49.4%。