新医学2025，Vol.56Issue(8)：778-784,7.DOI:10.12464/j.issn.0253-9802.2025-0009
耻骨弓角度与胎儿头围比值对分娩方式的预测价值
Predictive value of subpubic arch angle-to-fetal head circumference ratio for delivery mode
摘要
Abstract
Objective To evaluate the predictive value of the ratio of subpubic arch angle(SPA)to fetal head circumference(HC)(SPA/HC ratio)for the delivery mode of full-term pregnant women.Methods Clinical data of 363 pregnant women who received regular obstetric examination and vaginal trial of labor in Lingnan Hospital,the Third Affiliated Hospital of Sun Yat-sen University from July to December,2023 were retrospectively analyzed.According to the delivery mode,they were divided into normal vaginal delivery group(n=291)and cesarean delivery group(n=72).SPA and HC were measured by ultrasound after full-term pregnancy in all women.Mann-Whitney U test was used to compare SPA,HC and SPA/HC between two groups.The predictive values of SPA,HC and SPA/HC ratio for maternal delivery mode were assessed by Logistic regression analysis.The predictive efficiency of the model was evaluated by the receiver operating characteristic(ROC)curve.Results For 363 women with vaginal trial of labor,the average age was(30.33±4.40)years and the gestational age was(39.3±0.9)weeks.Compared with normal delivery group,the SPA was smaller and the HC was larger in the cesarean delivery group(both P<0.001).SPA yielded positive predictive value for normal delivery,with an area under the ROC curve(AUC)of 0.739(95%CI 0.678-0.799).HC had negative predictive value,with an AUC of 0.700(95%CI 0.637-0.763).SPA/HC yielded positive predictive value and the highest prediction efficiency,with an AUC of 0.817(95%CI 0.763-0.871).Conclusions SPA/HC ratio can effectively predict the delivery mode of full-term pregnant women.When SPA/HC ratio is less than 0.292,it is recommended to strengthen intrapartum fetal monitoring and prepare for emergency plan in advance.关键词
超声/耻骨弓角度/头围/分娩方式Key words
Ultrasound/Subpubic arch angle/Head circumference/Delivery mode引用本文复制引用
曾帅辉,欧阳丽萍,李秀红..耻骨弓角度与胎儿头围比值对分娩方式的预测价值[J].新医学,2025,56(8):778-784,7.基金项目
广东省基础与应用基础研究基金(2024A1515010979) （2024A1515010979）
广东省卫生计生适宜技术项目(202303281412244189) （202303281412244189）
