足月臀位外倒转术成功预测模型的建立与验证OACSTPCD

Objective:To develop and internally validate a predictive model for the success external cephalic version(ECV)in singleton term breech pregnancies.Methods:This is a retrospective single-center study among 485 singleton pregnant women who underwent ECV at Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2015 to September 2021.They were divided into a successful group and a failed group according to the surgical outcome.Multivariate analysis was performed using the logistic regression model to screen out the influencing factors of successful ECV as predictors to establish a predictive mod-el.The nomogram of the predictive model was constructed using R software.The receiver operat-ing characteristic(ROC)curve was drawn to evaluate the predictive performance of the model,and the Bootstrap method was used for internal validation.Results:Multiparity the use of toco-lytic agents,fetal weight＜2960g,amniotic fluid index≥11.3cm,non-anterior placenta,and nuchal cord＜2 weeks were independent favorable factors for the success of ECV.The above six factors were included as predictors to establish a predictive model and nomogram for the success of ECV.The area under the ROC curve of this predictive model was 0.74(95%CI:0.70～0.79),with a sensitivity of 71.43%and a specificity of 67.38%at this time.The internal vali-dation results of the model suggested that its predictive curve was consistent with the clinical ac-tual curve observed.Conclusion:The predictive model for the successful ECV in term breech pregnancies was developed based on the above predictors.It has good predictive efficacy and can provide a reference for obstetricians in clinical consultation and selection of appropriate populations for ECV.