Chen C P, Chang F M, Chang C H, Lin Y S, Chou C Y, Ko H C
Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, Tainan, Taiwan, R.O.C.
J Formos Med Assoc. 1993 Jan;92(1):24-8.
A total of 1,056 fetuses underwent single ultrasonographic measurement of fetal biparietal diameter (BPD), abdominal circumference (AC), femur length (FL), and estimated body weight within five days of delivery. The accuracy of these parameters and estimated body weight equations in the prediction of macrosomia (birth weight > or = 4,000 g) was evaluated. With the use of receiver operator characteristic curves, the optimal cutoff value for each parameter with the best sensitivity, specificity and accuracy was selected. BPDs > or = 9.4 cm had the best sensitivity (68.8%), specificity (74.3%), and accuracy (74.1%). ACs > or = 35 cm had the best sensitivity (81.3%), specificity (81.5%), and accuracy (81.5%). FLs > or = 7.0 cm had the best sensitivity (68.8%), specificity (74.5%), and accuracy (74.3%). The estimated body weight equations did not increase the prediction values whether or not FL was included. Both had the same prediction values at > or = 3,700 g, ie, sensitivity (71.9% vs 71.9%), specificity (92.1% vs 93.8%), and accuracy (91.5% vs 93.2%). The results showed AC to be the best single parameter for predicting macrosomia. Combinations of these parameters were better than a single parameter in the prediction of macrosomia.
共有1056例胎儿在分娩前5天内接受了胎儿双顶径（BPD）、腹围（AC）、股骨长度（FL）的单次超声测量以及估计体重。评估了这些参数和估计体重方程在预测巨大儿（出生体重≥4000g）方面的准确性。利用受试者工作特征曲线，选择了每个参数具有最佳敏感性、特异性和准确性的最佳临界值。双顶径≥9.4cm具有最佳敏感性（68.8%）、特异性（74.3%）和准确性（74.1%）。腹围≥35cm具有最佳敏感性（81.3%）、特异性（81.5%）和准确性（81.5%）。股骨长度≥7.0cm具有最佳敏感性（68.8%）、特异性（74.5%）和准确性（74.3%）。无论是否包含股骨长度，估计体重方程均未提高预测值。在≥3700g时两者具有相同的预测值，即敏感性（71.9%对71.9%）、特异性（92.1%对93.8%）和准确性（91.5%对93.2%）。结果显示腹围是预测巨大儿的最佳单一参数。在预测巨大儿时，这些参数的组合优于单一参数。
