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以第二产程中经会阴超声所测进展角预测分娩方式:Meta分析

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目的 采用meta分析观察以经会阴超声于第二产程所测进展角(AOP)预测分娩方式的价值.方法 检索数据库中2018年1月1日-2023年8月31日收录的有关第二产程超声测量AOP以预测分娩方式的中英文相关文献,由2名研究者根据纳入、排除标准筛选文献并提取资料,评估以经会阴超声于第二产程所测AOP预测分娩方式的价值;以诊断试验质量评价工具-2(QUADAS-2)评价纳入文献的质量.结果 最终纳入11篇研究、2 315名产妇.meta分析显示,在第二产程中以经会阴超声所测AOP预测分娩方式的合并敏感度(Sen)、合并特异度(Spe)、合并阳性似然比(+LR)、合并阴性似然比(-LR)及合并诊断比值比(DOR)分别为0.80[95%CI(0.76,0.83)]、0.83[95%CI(0.78,0.88)]、4.8[95%CI(3.5,6.6)]、0.24[95%CI(0.20,0.29)]及 20[95%CI(13,30)];其汇总受试者工作特征曲线下面积为0.88.结论 在第二产程中以经会阴超声所测AOP预测分娩方式的效能较好,可作为能否自然分娩成功的预测指标.
Angle of progression measured with transperineal ultrasound in the second stage of labor for predicting delivery mode:Meta-analysis
Objective To observe the value of angle of progression(AOP)measured with transperineal ultrasound in the second stage of labor for predicting delivery mode using meta-analysis.Methods Articles published in Chinese or English focused on the prediction of delivery mode using AOP measured with ultrasound during the second stage of labor were searched in databases from January 1,2018 to August 31,2023.The literature were screened by 2 researchers according to the inclusion and exclusion criteria,and information were extracted to assess the value of AOP measured in the second stage of labor with transperineal ultrasound for predicting delivery mode.The quality of the included literature were evaluated using Quality Evaluation Tool for Diagnostic Tests-2(QUADAS-2).Results Eleven studies including 2 315 parturient women were enrolled.Meta-analysis showed that the combined sensitivity(Sen),combined specificity(Spe),combined positive likelihood ratio(+LR),combined negative likelihood ratio(-LR),and combined diagnostic ratio(DOR)of AOP measured with transperineal ultrasound in the second stage of labor for predicting delivery mode was 0.80[95%CI(0.76,0.83)],0.83[95%CI(0.78,0.88)],4.8[95%CI(3.5,6.6)],0.24[95%CI(0.20,0.29)]and 20[95%CI(13,30)],respectively,while area under the summary receiver operating characteristic curve of 0.88.Conclusion AOP measured with transperineal ultrasound in the second stage of labor had fine efficiency for predicting delivery mode,which could be regarded as a useful predictor for probability of natural delivery.

labor stage,seconddelivery,obstetricultrasonographymeta-analysis

刘森、陈震宇、邢艳菲

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北部战区总医院锦州医科大学研究生培养基地,辽宁沈阳 110003

北部战区总医院和平院区妇产科,辽宁沈阳 110003

咸阳市中心医院妇产科,陕西咸阳 712000

产程,第二 接生,产科 超声检查 荟萃分析

2024

中国医学影像技术
中国科学院声学研究所

中国医学影像技术

CSTPCD北大核心
影响因子:0.763
ISSN:1003-3289
年,卷(期):2024.40(5)
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