孕中期超声检查对妊娠结局影响的循证研究

Effect of ultrasound examination at second trimester of pregnancy on pregnancy outcomes:an evidence-based research

目的：评估孕中期超声检查对孕产妇结局和新生儿结局是否有影响。方法：通过各种中文和外文的数据库检索19792010年5月的文献。中文库包括CNK、I万方和维普,外文库包括Elsevier,PubMed,EMBASE,Cochrane。纳入比较孕中期（1228周）实施超声检查与不实施超声检查的孕产妇结局和新生儿结局的随机化对照试验。使用Rev Man 5.0进行异质性检验和Meta分析。结果：共纳入8项研究。孕中期超声检查可增加孕产妇产前入院（OR 1.16,95%CI 1.021.34）,减少过期妊娠引产（OR 0.63,95% CI 0.490.80）、减少多胎妊娠漏诊（OR 0.09,95% CI 0.020.34）,以及减少低出生体重儿（OR0.80,95% CI 0.650.99）。结论：孕中期超声检查能够更好地评估孕周,及时识别多胎妊娠以及低出生体重儿。目前还没有明确的证据表明孕中期超声检查对孕妇及胎儿有害。

Objective：To evaluate the effect of ultrasound examination at second trimester of pregnancy on maternal and fetal outcomes.Methods：The literatures from 1979 to May 2010 were searched from various Chinese databases and foreign language databases;the Chinese databases included CNKI,Wanfang database and Weipu database;the foreign language databases included Elsevier,Pub Med,EMBASE and Cochrane.The randomized controlled trials that compared maternal and fetal outcomes of ultrasound examination and non-ultrasound examination at second trimester of pregnancy were included;Rev Man 5.0 software was used for heterogeneity test and Meta analysis.Results：8 trials were included in the study;ultrasound examination at second trimester of pregnancy increased the rate of hospital admission before delivery（OR =1.16,95% CI ：1.02～1.34）,reduced the induced labor rate of prolonged pregnancy（OR =0.63,95% CI ：0.49～0.80）,the misdiagnosis rate of multiple pregnancy（OR =0.09,95% CI ：0.02～0.34） and the birth rate of low birth weight infants（OR =0.80,95% CI ：0.65～0.99）.Conclusion：Ultrasound examination at second trimester of pregnancy can evaluate gestational weeks more accurately,distinguish multiple pregnancy and low birth weight infants timely;until now,there is no clear evidence that ultrasound examination at second trimester of pregnancy is harmful.