Value evaluation of fetal distress prediction indexes and establishment and verification of prediction model
10.3969/j.issn.1671-8348.2024.17.015
- VernacularTitle:胎儿窘迫预测指标的价值评估及预测模型的建立与验证
- Author:
Yan MA
1
;
Kai YANG
;
Peng XU
;
Shanshan WANG
;
Yihu MA
;
Xiaoxue ZHAO
;
Junru ZHANG
;
Jun LI
;
Xiangdong MA
Author Information
1. 空军军医大学第一附属医院妇产科,西安 710032
- Keywords:
fetal distress;
ultrasonography,doppler,color;
middle cerebral artery;
umbilical arteries;
risk prediction model
- From:
Chongqing Medicine
2024;53(17):2637-2642
- CountryChina
- Language:Chinese
-
Abstract:
Objective To use color Doppler ultrasound to measure the hemodynamic indexes,and to es-tablish the diagnostic prediction model of inflammatory fetal distress.Methods A total of 213 pregnant women admitted to the obstetrics department of the First Affiliated Hospital of Air Force Military Medical U-niversity were collected as the research subjects and divided into the control group and case group according to whether or not fetal distress occurred,including 93 cases in the control group and 120 cases in the case group.The predictive value of PI,RI,S/D values of middle cerebral artery,umbilical artery and uterine artery for pre-dicting fetal distress was analyzed The diagnostic model was constructed by logistic regression analysis.The receiver operating characteristic(ROC)curve,calibration curve and clinical decision curve were adopted to an-alyze and evaluate the diagnostic efficiency of the model for adverse perinatal outcome and the clinical benefit of the patients.Results The univariate analysis results showed that MCA-PI,MCA-RI,MCA,S/D and CPR in the case group were lower than those in the control group,while UA-RI,UA,S/D and UtA-RI were higher than those in the control group.The multivariate regression analysis further showed that MCA-PI,MCA-RI and CPR were the independent protective factors for predicting fetal distress,while UA-R1 and UA-S/D served as the independent risk factors affecting the fetal outcome.Based on five independent influencing fac-tors,the risk prediction model was constructed,and the area under the receiver operating characteristic curve was 0.880(95％CI:0.834-0.925).The sensitivity,specificity and accuracy were 0.93,0.70 and 0.83 respec-tively,and the goodness of fit was good.Conclusion The hemodynamic indexes measured by color Doppler ul-trasound have good predictive value for the diagnosis of fetal distress.The risk prediction model established by the combined indexes has a certain reference value for the intervention in advance of pregnant women with fe-tal distress occurence.
