Hallak M, Kirshon B, O'Brian Smith E, Evans M I, Cotton D B
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Tex.
Fetal Diagn Ther. 1993 Jul-Aug;8(4):256-60. doi: 10.1159/000263836.
The purpose of this study was to evaluate the ability to identify abnormalities in amniotic fluid volume by subjective ultrasonographic assessment compared to a semiobjective method. In 886 consecutive ultrasound examinations subjective assessment of the amniotic fluid volume was performed and graded into 3 categories: normal, decreased, and increased. Following that, a four-quadrant sum (amniotic fluid index) was performed by the same experienced ultrasonographer and divided into 3 categories using the 5th and 95th percentiles. The sensitivity of the subjective analysis to diagnose a decreased amniotic fluid volume when compared with the amniotic fluid index was 58% (95% confidence interval, CI: 40-70%), with a false-positive rate of 17% (CI 8-32%). The sensitivity of the subjective analysis to diagnose an increased amniotic fluid volume when compared with the amniotic fluid index was 100% (CI 70-100%). However, the false-positive rate was 74% (CI 55-85%). Diagnosis of a normal amount of amniotic fluid by the subjective technique had a sensitivity of 96% (CI 95-97%) and a false-positive rate of 3% (CI 2-4%). Subjective ultrasonographic assessment of the amniotic fluid volume may serve as a screening test for the experienced ultrasonographer. However, when a decreased or increased amount of amniotic fluid volume is suspected, one may elect to use the amniotic fluid index for confirmation of the subjective impression.
本研究的目的是评估与半客观方法相比，通过主观超声评估识别羊水量异常的能力。在886例连续超声检查中，对羊水量进行了主观评估，并分为3类：正常、减少和增加。随后，由同一位经验丰富的超声检查医师进行四象限总和测量（羊水指数），并使用第5和第95百分位数将其分为3类。与羊水指数相比，主观分析诊断羊水量减少的敏感性为58%（95%置信区间，CI：40-70%），假阳性率为17%（CI 8-32%）。与羊水指数相比，主观分析诊断羊水量增加的敏感性为100%（CI 70-100%）。然而，假阳性率为74%（CI 55-85%）。主观技术诊断羊水量正常的敏感性为96%（CI 95-97%），假阳性率为3%（CI 2-4%）。对于经验丰富的超声检查医师，主观超声评估羊水量可作为一种筛查试验。然而，当怀疑羊水量减少或增加时，可选择使用羊水指数来证实主观印象。
