Chauhan S P, Sullivan C A, Lutton T C, Magann E F, Morrison J C
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
J Perinatol. 1995 May-Jun;15(3):192-4.
Our objective was to determine among postterm gestations (gestational age > or = 41 weeks) the accuracy of a parous patient's (n = 70) estimate of her newborn's birth weight and to compare the accuracy of clinical prediction with the assessment by the parturient (n = 40). During early labor 70 postterm parous subjects were asked to predict the birth weight of their neonate on the basis of their prior obstetric experiences. For comparison, a concurrent clinical estimate of the birth weight by the provider was also obtained in 40 of these patients. The incidence of macrosomia (birth weight > or = 4000 gm) among postterm parous mothers was 25.7%. The mean standardized error of the maternal estimate of birth weight was 85 +/- 76 gm/kg and 71.4% of their estimates were within +/- 10% of actual birth weight. Maternal estimate of birth weight > or = 4000 gm had a 94% specificity and 77% positive predictive value for a macrosomic fetus. Among 40 postterm parous women the clinical estimate had a mean standardized error (75 +/- 71 gm/kg) comparable to that of the maternal prediction (92 +/- 81 gm/kg) of birth weight (p = not significant). The mean standardized error among estimates for 11 macrosomic newborn infants who underwent both methods of estimation of birth weight was not significantly different. In conclusion, postterm parous women are at risk for delivery of a macrosomic fetus. Among these parturients, an estimate of birth weight by parous women is comparable to the clinical prediction of newborn weight by their providers.
我们的目的是确定在过期妊娠（孕周≥41周）中，经产妇（n = 70）对其新生儿出生体重估计的准确性，并将临床预测的准确性与产妇本人的评估（n = 40）进行比较。在产程早期，70名过期妊娠的经产妇被要求根据她们既往的产科经验预测其新生儿的出生体重。为作比较，其中40名患者还同时获得了医护人员对出生体重的临床估计。过期妊娠经产妇中巨大儿（出生体重≥4000克）的发生率为25.7%。产妇对出生体重估计的平均标准化误差为85±76克/千克，且她们71.4%的估计值与实际出生体重相差±10%以内。产妇对出生体重≥4000克的估计对于巨大儿胎儿具有94%的特异性和77%的阳性预测值。在40名过期妊娠经产妇中，临床估计的平均标准化误差（75±71克/千克）与产妇对出生体重的预测（92±81克/千克）相当（p = 无显著差异）。对11名接受了两种出生体重估计方法的巨大儿新生儿的估计值之间，平均标准化误差无显著差异。总之，过期妊娠经产妇有分娩巨大儿的风险。在这些产妇中，经产妇对出生体重的估计与医护人员对新生儿体重的临床预测相当。
