Smith R S, Bottoms S F
Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, MI.
Am J Obstet Gynecol. 1993 Sep;169(3):490-3. doi: 10.1016/0002-9378(93)90606-j.
Our purpose was to improve the accuracy of prenatal prognostication by directly correlating obstetric ultrasonographic measurements with neonatal survival.
We studied 130 singleton live-born infants with birth weights between 500 and 1000 gm and who underwent complete ultrasonographic examinations within 3 days of delivery. Ultrasonographic measurements were evaluated as screening tests for neonatal survival by means of receiver-operator characteristic curves and compared with birth weight and pediatric assessment of gestational age.
Eighty infants survived, and 50 died. Visual inspection of the receiver-operator characteristic curves indicated that biparietal diameter was the best predictor of survival. While correctly identifying all survivors, biparietal diameter predicted nonsurvivors better (p < 0.0001) than did actual birth weight or any other variable.
Our findings indicate that using biparietal diameter to determine neonatal prognosis is significantly more reliable than the current practice of using estimated fetal weight. We speculate that biparietal diameter may reflect maturity more accurately because it is less subject to variation in growth.
我们的目的是通过将产科超声测量结果与新生儿存活率直接关联，提高产前预后评估的准确性。
我们研究了130例出生体重在500至1000克之间的单胎活产婴儿，这些婴儿在分娩后3天内接受了完整的超声检查。通过受试者工作特征曲线评估超声测量结果作为新生儿存活的筛查试验，并与出生体重和儿科对孕周的评估进行比较。
80例婴儿存活，50例死亡。对受试者工作特征曲线的直观检查表明，双顶径是存活的最佳预测指标。在正确识别所有存活者的同时，双顶径对非存活者的预测优于实际出生体重或任何其他变量（p<0.0001）。
我们的研究结果表明，使用双顶径来确定新生儿预后比目前使用估计胎儿体重的做法显著更可靠。我们推测，双顶径可能更准确地反映成熟度，因为它受生长变化的影响较小。
