Faculty of Medicine of University of Coimbra, Obstetrics Department, University and Hospitalar Centre of Coimbra, Coimbra, Portugal.
Maternidade Doutor Daniel de Matos, R. Miguel Torga, 3030-165, Coimbra, Portugal.
Sci Rep. 2024 Jul 3;14(1):15275. doi: 10.1038/s41598-024-65394-6.
Providing adequate counseling on mode of delivery after induction of labor (IOL) is of utmost importance. Various AI algorithms have been developed for this purpose, but rely on maternal-fetal data, not including ultrasound (US) imaging. We used retrospectively collected clinical data from 808 subjects submitted to IOL, totaling 2024 US images, to train AI models to predict vaginal delivery (VD) and cesarean section (CS) outcomes after IOL. The best overall model used only clinical data (F1-score: 0.736; positive predictive value (PPV): 0.734). The imaging models employed fetal head, abdomen and femur US images, showing limited discriminative results. The best model used femur images (F1-score: 0.594; PPV: 0.580). Consequently, we constructed ensemble models to test whether US imaging could enhance the clinical data model. The best ensemble model included clinical data and US femur images (F1-score: 0.689; PPV: 0.693), presenting a false positive and false negative interesting trade-off. The model accurately predicted CS on 4 additional cases, despite misclassifying 20 additional VD, resulting in a 6.0% decrease in average accuracy compared to the clinical data model. Hence, integrating US imaging into the latter model can be a new development in assisting mode of delivery counseling.
为引产(IOL)后的分娩方式提供充分的咨询至关重要。为此已经开发了各种人工智能算法,但这些算法依赖于不包括超声(US)成像的母婴数据。我们使用从 808 名接受 IOL 的受试者中回顾性收集的临床数据,总共 2024 张 US 图像,来训练 AI 模型以预测 IOL 后的阴道分娩(VD)和剖宫产(CS)结局。整体最佳模型仅使用临床数据(F1 评分:0.736;阳性预测值(PPV):0.734)。成像模型使用胎儿头部、腹部和股骨 US 图像,显示出有限的鉴别结果。使用股骨图像的最佳模型(F1 评分:0.594;PPV:0.580)。因此,我们构建了集成模型来测试 US 成像是否可以增强临床数据模型。最佳的集成模型包括临床数据和股骨 US 图像(F1 评分:0.689;PPV:0.693),呈现出有趣的假阳性和假阴性权衡。该模型在另外 4 个病例中准确预测了 CS,尽管错误地将另外 20 个 VD 归类,与临床数据模型相比,平均准确性降低了 6.0%。因此,将 US 成像集成到后者模型中可能是辅助分娩方式咨询的新发展。
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