目的:探讨腹内扩张(IABD)在复杂性胃裂预测中的作用。
方法:这是一项对174例单胎妊娠合并单胎腹裂的回顾性研究,导致活产和可用的超声图像在20-22和30-32周妊娠。IABD被测量为最扩张的腹内肠段的最大横径,一位对产后结局视而不见的操作员。确定了复杂和简单胃裂的IABD测量值的分布,并使用接收器工作特征(ROC)曲线选择了预测复杂胃裂的最佳临界值。ROC曲线下面积(AUC),检测率(DR),假阳性率(FPR),确定阳性预测值(PPV)和阴性预测值(NPV)。
结果:研究人群包括39例(22.4%)复杂和135例(77.6%)单纯性腹裂。在复杂腹裂的预测中,妊娠20~22周时的AUC为0.742(95%CI,0.628~0.856),30~32周时的AUC为0.820(95%CI,0.729~0.910).在20-22周时,IABD截止值为7毫米,DR,FPR,复杂腹裂的PPV和NPV分别为61.5%,6.7%,72.7%和89.4%,分别,在30-32周时,IABD截止值为14毫米,分别为64.9%,5.9%,75.0%和90.7%。
结论:在妊娠20-22或30-32周测量IABD对预测复杂的胃裂是有用的。版权所有©2019ISUOG。由JohnWiley&SonsLtd.发布.
OBJECTIVE: To investigate intra-abdominal bowel dilation (IABD) in the prediction of complex gastroschisis.
METHODS: This was a retrospective study of 174 singleton pregnancies with isolated fetal gastroschisis, resulting in live birth and with available ultrasound images from visits at both 20-22 and 30-32 weeks\' gestation. IABD was measured as the greatest transverse diameter of the most dilated intra-abdominal bowel segment, by an operator blinded to postnatal outcome. The distribution of IABD measurements in those with complex and those with simple gastroschisis was determined and the best cut-off value to predict complex gastroschisis was selected using receiver-operating characteristics (ROC) curves. The area under the ROC curve (AUC), detection rate (DR), false-positive rate (FPR), positive predictive value (PPV) and negative predictive value (NPV) were determined.
RESULTS: The study population included 39 (22.4%) cases of complex and 135 (77.6%) cases of simple gastroschisis. In the prediction of complex gastroschisis, the AUC at 20-22 weeks\' gestation was 0.742 (95% CI, 0.628-0.856) and the respective value for 30-32 weeks was 0.820 (95% CI, 0.729-0.910). At the IABD cut-off of 7 mm at 20-22 weeks, DR, FPR, PPV and NPV for complex gastroschisis were 61.5%, 6.7%, 72.7% and 89.4%, respectively, and at IABD cut-off of 14 mm at 30-32 weeks, the respective values were 64.9%, 5.9%, 75.0% and 90.7%.
CONCLUSIONS: Measurement of IABD at 20-22 or at 30-32 weeks\' gestation is useful in the prediction of complex gastroschisis. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.