宫扩张的产后超声波:观察者之间和观察者内部的协议
Arwa Hanidu1,2, Mariya Kovalenko1,2, Sana Usman1,2
1Queen Charlotte's and Chelsea Hospital, Imperial Healthcare NHS Trust, London, UK.
Acta obstetricia et gynecologica Scandinavica
|September 15, 2024
概括
跨膜超声波 (TPUS) 是评估分娩期间宫扩张的可行方法,与数字阴道检查 (DVE) 有着很强的相关性. 这种成像技术证明了观察者之间和观察者内部的良好协议,为分娩进展监测提供了可靠的替代方案.
科学领域:
- 产科和妇科 产科和妇科
- 医疗成像医学成像
- 劳动和交付工作
背景情况:
- 数字阴道检查 (DVE) 是评估分娩进展的标准,但它是主观的,并带有风险.
- 观察者间和观察者内部的变化是已知的DVE问题.
- 有限的数据存在于产妇宫扩张评估的产妇宫超声波 (TPUS) 的可变性.
研究的目的:
- 通过TPUS和DVE测量宫扩张之间的关系.
- 评估TPUS在活动分娩期间测量宫扩张的观察者间和观察者内变异性.
主要方法:
- 伦敦的一项单一中心研究招募了206名在活跃劳动中从事 nulliparous 的参与者.
- 在DVE之后进行了跨膜超声波 (TPUS),并在可行的情况下重复评估.
- 使用2D cine-loop视频测量了宫前后 (AP) 直径.
主要成果:
- 110名参与者获得了147个对TPUS和DVE观测结果;34%的测量结果相同,46.3%的测量结果差异为1厘米.
- TPUS和DVE之间的平均差异为-0.9厘米 (ICC=0.85,p<0.001).
- 观察者之间的变异性显示平均差异为0.07厘米 (95%的LOA-0.96到1.10),观察者内部的变异性显示为0.01厘米 (95%的LOA-0.29到0.30).
结论:
- TPUS是活跃分娩期间宫评估的可行方法,与DVE有很强的相关性.
- 大多数TPUS测量在DVE值的1厘米以内.
- 对于宫扩张,TPUS显示出高的类内相关性和良好的观察者间和观察者内一致性.
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