巨大儿预测方法的比较研究

Comparative study of the prediction method in measurement of fetal macrosomia

目的比较分析适合基层医院开展产前预测巨大儿的方法。方法收集2014年6月1日至2015年5月31日在北京市西城区展览路医院住院分娩的初产单胎的产妇，产前经超声或临床测量方法怀疑为巨大儿者共100例，产后对预测后实际分娩为巨大儿产妇资料进行分析，通过比较分析各估计胎儿体重的方法对判断巨大儿的预测准确性。结果预测人组共100例，产后分娩巨大儿76例。临床与超声结合法预测诊断巨大儿法较单纯临床测量孕妇宫高腹围诊断法的诊断正确率更高，NRI=0．549。各测量方法拟合ROC曲线比较曲线下面积，宫高腹围积法AUC为0．886，较其他方法均高。结论临床宫高腹围积法和超声检查相结合的方式更能有效地预估算巨大儿的体重。

Objective To compare and analyze the method of estimating fetal weight which can used in the Grass-roots hospital. Methods 100 pregnant women with singleton fetuses were enrolled, who were hospitalized and delivered in Exhibition Road Hospital from June 1, 2014 to May 31, 2015. All of the 100 cases were suspected to be macrosomia by ultrasound or clinical measurement beforedelivery. After delivery, the clinical data were analyzed, by comparing the estimated and actual fetal weight, to determine the accuracy of macrosomia prediction. Results There were 76 cases of practical macrosomia after delivery. The diagnostic accuracy of the method of clinical data combined with ultrasonography was higher than the simple clinical measurement （the high of uterine and abdominal circumference of the pregnant women）, NRI = 0.549. Each measurement method fitting area under the curve of ROC comparison, the product of the height of uterine and abdominal circumference was higher than other methods. AUC=0.886. Conclusion Clinical measurement combined with ultrasono^ranhv is more effective in nredictin~, hodv wei~,ht of macrosomia.