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用于阴道臀位分娩评估的新型三维全身扫描人体测量学与磁共振骨盆测量法对比

Novel Three-Dimensional Body Scan Anthropometry versus MR-Pelvimetry for Vaginal Breech Delivery Assessment.

作者信息

Dathan-Stumpf Anne, Lia Massimiliano, Meigen Christof, Bornmann Karoline, Martin Mireille, Aßmann Manuela, Kiess Wieland, Stepan Holger

机构信息

Department of Obstetrics, University Hospital Leipzig, 04103 Leipzig, Germany.

LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany.

出版信息

J Clin Med. 2023 Sep 25;12(19):6181. doi: 10.3390/jcm12196181.

Abstract

In this prospective, monocentric study, we investigated the potency of a novel three-dimensional (3D) body scanner for external pelvic assessment in birth planning for intended vaginal breech delivery. Between April 2021 and June 2022, 73 singleton pregnancies with intended vaginal birth from breech presentation (>36.0 weeks of gestation) were measured using a pelvimeter by Martin, a three-dimensional body scanner, and MR-pelvimetry. Measures were related to vaginal birth and intrapartum cesarean section. A total of 26 outer pelvic dimensions and 7 inner pelvic measurements were determined. The rate of successful vaginal breech delivery was 56.9%. The AUC (area under the curve) of the obstetric conjugate (OC) measured by MRI for predicting the primary outcome was 0.62 (OR 0.63; = 0.22), adjusted for neonatal birth weight 0.66 (OR 0.60; = 0.19). Of the 22 measured 3D body scanner values, the ratio of waist girth to maternal height showed the best prediction (AUC = 0.71; OR 1.27; = 0.015). The best predictive pelvimeter value was the distantia spinarum with an AUC of 0.65 (OR = 0.80). The 3D body scanner technique is at least equal to predict successful vaginal breech delivery compared to MRI diagnostics. Further large-scale, prospective studies are needed to verify these results.

摘要

在这项前瞻性单中心研究中,我们调查了一种新型三维(3D)人体扫描仪在计划经阴道臀位分娩的生育计划中进行骨盆外部评估的效能。在2021年4月至2022年6月期间,对73例孕周>36.0周、计划经阴道分娩的单胎臀位妊娠孕妇,使用马丁骨盆测量仪、三维人体扫描仪和磁共振骨盆测量法进行测量。测量指标与经阴道分娩和产时剖宫产相关。共确定了26个骨盆外部尺寸和7个骨盆内部测量值。经阴道臀位分娩成功率为56.9%。MRI测量的产科结合径(OC)预测主要结局的曲线下面积(AUC)为0.62(比值比0.63;P = 0.22),校正新生儿出生体重后为0.66(比值比0.60;P = 0.19)。在22个测量的三维人体扫描仪值中,腰围与母亲身高的比值预测效果最佳(AUC = 0.71;比值比1.27;P = 0.015)。骨盆测量仪的最佳预测值是髂棘间径,AUC为0.65(比值比 = 0.80)。与MRI诊断相比,三维人体扫描仪技术在预测经阴道臀位分娩成功方面至少具有同等效果。需要进一步开展大规模前瞻性研究来验证这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1d4/10573905/f8756104bcbf/jcm-12-06181-g001.jpg

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