胎儿头位的确定:妇产科教授与住院医师是否达成一致?

F. Akhlaghi, Fereshteh Bazmi, M. Najafi
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摘要

背景:胎儿头位的测定是分娩过程中的重要因素。本研究评估了在产程中基于阴道检查确定胎儿头位的妇产科教授和住院医师之间的一致性和相关性。方法:在这项横断面研究中,在分娩活跃期出现头位的足月孕妇同时接受了住院医师和妇产科教授的阴道检查。他们的检查结果关于胎儿头位,宫颈扩张和消失记录由教授和住院医师。采用SPSS version 16对两组评估者(住院医师和教授)所得结果进行Spearman相关检验和class内相关系数检验。结果:我们的资料分析显示,产科医生和住院医师对宫颈扩张、宫颈消退和胎头位的一致性分别为0.88、0.9和0.67 (p <0.001)。产科医师和住院医师对宫颈扩张、宫颈消退和胎头位的相关性分别为0.77、0.79和0.52 (p <0.001)。结论:妇产科医师和住院医师对胎儿头位测定的一致性和相关性低于宫颈扩张和宫颈消融测定。鉴于在产程第一阶段准确测定胎头位置的重要性,应开发一种新的方法(新发明的胎头位置测定装置)来测定胎头位置。
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Determination of fetal head station: Do professors and residents of obstetrics and gynecology reach an agreement?
Background: Determination of fetal head station is an important factor during labor progress. This study evaluated the agreement and correlation between professors and residents of obstetrics and gynecology in the determination of fetal head station based on a vaginal examination during labor.  Methods: In this cross-sectional study, term pregnant women with cephalic presentation in an active phase of labor underwent vaginal examinations simultaneously by residents and professors of obstetrics and gynecology. Their examination findings regarding a fetal head station, cervical dilation and effacement were recorded both by professors and the residents. Data were analyzed by SPSS version 16 using Spearman’s correlation and Intraclass Correlation Coefficient tests between results obtained by two groups of assessors (residents and professors). Results: Our data analysis showed that the agreement between obstetricians and residents for cervical dilatation, cervical effacement, and a fetal head station was 0.88, 0.9 and 0.67 respectively (p <0.001). The correlation between obstetricians and residents for determination of cervical dilatation, cervical effacement and, a fetal head station was 0.77, 0.79 and 0.52, respectively (p <0.001). Conclusions: The agreement and correlation between professors and residents in obstetrics and gynecology about the determination of fetal head station are lower than those for cervical dilatation and effacement. Because of the importance of accurate determination of fetal head station in the first stage of labor, a new approach (new invented device for determine fetal head station) should be developed to for determining of fetal station.
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