Phelps J Y, Higby K, Smyth M H, Ward J A, Arredondo F, Mayer A R
Department of Obstetrics and Gynecology, Brooke Army Medical Center, San Antonio, Texas, USA.
Am J Obstet Gynecol. 1995 Sep;173(3 Pt 1):942-5. doi: 10.1016/0002-9378(95)90371-2.
Our purpose was to assess the accuracy and intraobserver variability of clinical cervical diameter measurements among obstetric health care providers.
Polyvinyl chloride pipes 1 to 10 cm in diameter were mounted in cardboard boxes and used to simulate cervical examinations. The boxes were designed so that the examiner had to rely solely on proprioception to determine the inner diameter.
A total of 1574 simulated cervical diameter measurements were obtained from 102 different examiners in a two-part study. The overall accuracy for determining the exact diameter was 56.3%, which improved to 89.5% when an error of +/- 1 cm was allowed. Intraobserver variability for a given diameter measurement was 52.1%, which decreased to 10.5% when an error of +/- 1 cm was allowed.
Cervical diameter measurements obtained by digital examination are precise when an error of +/- 1 cm is allowed for. Intraobserver variability is > 50% and is an important consideration when evaluating dysfunctional labor.
我们的目的是评估产科医护人员临床测量宫颈直径的准确性和观察者内变异性。
将直径1至10厘米的聚氯乙烯管安装在硬纸盒中，用于模拟宫颈检查。盒子的设计使得检查者必须完全依靠本体感觉来确定内径。
在一项分为两部分的研究中，从102名不同的检查者那里总共获得了1574次模拟宫颈直径测量值。确定确切直径的总体准确率为56.3%，当允许有±1厘米的误差时，准确率提高到89.5%。给定直径测量的观察者内变异性为52.1%，当允许有±1厘米的误差时，变异性降至10.5%。
当允许有±1厘米的误差时，通过指诊获得的宫颈直径测量值是精确的。观察者内变异性大于50%，在评估产程异常时是一个重要的考虑因素。
