A prospective study using an individualized nomogram to predict the success rate of external cephalic version

被引:9
作者
Lin, Jing [1 ,2 ,3 ]
Liu, Wei [1 ,2 ,3 ]
Gu, Wei [1 ,2 ,3 ]
Zhou, Ye [1 ,2 ,3 ]
机构
[1] Shanghai Jiao Tong Univ, Sch Med, Int Peace Matern & Child Hlth Hosp, 910 Hengshan Rd, Shanghai 200030, Peoples R China
[2] Shanghai Key Lab Embryo Original Dis, Shanghai, Peoples R China
[3] Shanghai Municipal Key Clin Specialty, Shanghai, Peoples R China
关键词
RANDOMIZED CONTROLLED-TRIAL; BREECH PRESENTATION; TERM; WOMEN;
D O I
10.1038/s41598-022-16112-7
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
To establish a clinical-based nomogram for predicting the success rate of external cephalic version (ECV) through a prospective study. This was a single-center prospective study that collected eligible breech pregnant women. 152 participants were enrolled in the training cohort, who received ECV procedures performed by a single operator. We used the training cohort to establish regression equations and prediction models. These variables include maternal factors (age, operation gestational age, pre-pregnancy BMI (Body Mass Index), operation BMI, BMI increase, multipara), ultrasound factors (fetal weight estimation, amniotic fluid index, placental location, type of breech presentation, spinal position), and anesthesia. Univariate and multivariable analyses were used to screen the factors affecting the success of ECV. A nomogram scoring model was established based on these factors. And C-index, DCA (Decision Curve Analysis) and calibration curve, Hosmer-Lemeshow test was used to verify the prediction effect of the model. Finally, 33 participants were enrolled in the testing cohort who received ECV with an unrestricted operator. We used C-index, DCA (decision curve analysis), and Hosmer-Lemeshow to verify the application value of the prediction model. The calibration curves and ROC curves of both the training cohort and testing cohort are plotted for internal and external validation of the model. The ECV success rate of the training cohort was 62.5%. Univariate analysis showed that the predictors related to the success rate of ECV were age, BMI increase value, AFI (amniotic fluid index), breech type, placental location, spinal position, anesthesia, and multipara. The prediction thresholds of the corresponding indexes were calculated according to the Youden index. Multivariate logistic regression analysis showed that BMI increase >= 3.85 kg/m(2), AFI >= 10.6 cm, anesthesia, multipara, and non-anterior placenta were independent predictors of ECV success. Through the internal and external validation, it is confirmed that the model has a good calibration and prediction ability. Our nomogram has a good ability to predict the success rate of ECV.
引用
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页数:12
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