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孕晚期准确测量估测胎儿体质量(estimation fetal weight,EFW)对减少产科并发症具有十分重要的意义[1-2]。产前超声检查是产科影像诊断较为常用的工具,应用超声并根据胎儿器官、容积等的大小,并通过公式分析可得到较为准确的结论,不过遗憾的是重复性差,且分娩前对预测EFW的敏感性和准确性不高[3-4]。二维超声在各级医院均已普及,因此提高二维超声对EFW估测的准确性具有积极的作用[5]。本次研究选择孕晚期(超过孕36周)的孕妇在膀胱充盈前后分别行二维超声估测EFW,并与实际体质量进行对比,为临床孕晚期估测EFW提供更多依据。现作报道。
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超声检查结果显示,产妇膀胱充盈时胎儿双顶径及头围的标准切面获取率为(91/108),产妇膀胱未充盈时胎儿双顶径及头围的标准切面获取率为(68/108),2组差异有统计学意义(χ2=12.61,P < 0.01)。胎儿头围和体质量在产妇膀胱充盈、膀胱未充盈及实际出生时差异有统计学意义(P < 0.01);胎儿头围和体质量在产妇膀胱充盈时测量值与实际出生时差异无统计学意义(P>0.05),膀胱未充盈时测量值显著低于膀胱充盈时和实际出生时(P < 0.01)(见表 1)。
分组 n 双顶径/mm 股骨长/mm 腹围/mm 头围/mm 体质量/g 膀胱充盈时 108 93.1±9.6 72.1±6.4 360.5±40.1 340.2±18.4 3 547±321 膀胱未充盈时 108 90.1±7.1 72.8±6.9 354.9±35.8 332.9±16.1** 3 407±319** 实际出生时 108 — — — 342.7±19.8## 3 531±301## F — 2.61Δ 0.77Δ 1.08Δ 8.49 6.44 P — < 0.05 >0.05 >0.05 < 0.01 < 0.01 MS组内 — — — — 329.937 98 467.667 q检验:与膀胱充盈时比较** P < 0.01;与膀胱未充盈时比较##P < 0.01;Δ示t值 表 1 胎儿生长发育参数及体质量比较(x±s)
膀胱充盈后超声检查孕晚期产妇估测胎儿体质量的准确性研究
Study on the accuracy of estimation fetal weight during postpregnancy by ultrasonographic examination after bladder filling
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摘要:
目的研究膀胱充盈后超声检查对孕晚期产妇估测胎儿体质量(EFW)测量的准确性及应用价值。 方法选择正常头位单胎产妇108例,均于分娩前1周内于膀胱充盈及未充盈时行产前经腹二维超声检查,观察胎儿生长发育参数,并通过Hadlock公式测量EFW。 结果产妇膀胱充盈时胎儿双顶径及头围的标准切面获取率为(91/108),产妇膀胱未充盈时胎儿双顶径及头围的标准切面获取率为(68/108),2组差异有统计学意义(P < 0.01)。胎儿头围和体质量在产妇膀胱充盈、膀胱未充盈及实际出生时差异有统计学意义(P < 0.01);胎儿头围和体质量在产妇膀胱充盈时测量值与实际出生时差异无统计学意义(P>0.05),膀胱未充盈时测量值显著低于膀胱充盈时和实际出生时(P < 0.01)。 结论孕晚期产妇膀胱充盈后行经腹二维超声检查可有效提高胎儿双顶径及头围的标准切面准确率,EFW更接近出生时实际质量,可以为临床医生判断胎儿体质量提供帮助。 Abstract:ObjectiveTo explore the accuracy and application value of ultrasonographic examination after bladder filling in evaluating fetal weight during postpregnancy. MethodsOne hundred and eight normal head position single fetal maternal were examined using 2D ultrasound in bladder filling and unfilling within 1 week before delivery, the fetal growth parameters were observed, and the estimation fetal weight (EFW) was measured using the Hadlock formula. ResultsThe standard shear rates of fetal double top diameter and head circumference at bladder filling and unfilling were 91/108 and 68/108, respectively, and the difference of which was statistically significant (P < 0.01).The differences of the fetal head circumference and body weight in puerperal with bladder unfilling between fetus and actual birth were statistically significant (P < 0.01), and the differences of the fetal head circumference and body weight in puerperal with bladder filling between fetus and actual birth were not statistcially significant (P>0.05).The fetal head circumference and body weight in puerperal with bladder unfilling were significantly lower than those in puerperal with bladder filling and actual birth (P < 0.01). ConclusionsThe 2D ultrasonographic examination in puerperal with bladder filling can effectively improve the accuracy of the standard section of fetal double top diameter and head circumference, the fetal body quality estimated is closer to the actual quality of birth, which can provide the help in clinicians to judge and estimate fetal body weight. -
Key words:
- prenatal examination /
- bladder filling /
- ultrasonic examination /
- estimation fetal weight
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表 1 胎儿生长发育参数及体质量比较(x±s)
分组 n 双顶径/mm 股骨长/mm 腹围/mm 头围/mm 体质量/g 膀胱充盈时 108 93.1±9.6 72.1±6.4 360.5±40.1 340.2±18.4 3 547±321 膀胱未充盈时 108 90.1±7.1 72.8±6.9 354.9±35.8 332.9±16.1** 3 407±319** 实际出生时 108 — — — 342.7±19.8## 3 531±301## F — 2.61Δ 0.77Δ 1.08Δ 8.49 6.44 P — < 0.05 >0.05 >0.05 < 0.01 < 0.01 MS组内 — — — — 329.937 98 467.667 q检验:与膀胱充盈时比较** P < 0.01;与膀胱未充盈时比较##P < 0.01;Δ示t值 -
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