妊娠12～24周胎盘体积的实时三维彩超测量研究

Placental volume measured by real time 3-dimensional ultrasonography in normal pregnancies from 12 to 24 gestational weeks

目的:利用实时三维彩色超声测量中孕胎盘体积,初步探讨胎盘体积与孕龄和胎儿生长发育的关系,为进一步研究胎盘体积预测胎儿生长受限(FGR)的可行性提供依据。方法:2009年6月至12月于西安交通大学医学院第一附属医院妇产科B超室就诊的孕妇中,选择孕12周至24周无合并症和并发症的单胎妊娠,总计检查次数516次,孕妇年龄18～41岁,平均孕龄(129.10±23.42)天(12+0周到24+6周)。采用Philip HDI-4000型彩色多普勒超声诊断仪,检查胎儿并测量双顶径、股骨长、顶臀径,观察羊水、胎盘情况,采用实时三维超声VOCAL法测量胎盘体积。结果:(1)妊娠12+0到24+6周胎盘体积中位数范围为55.61～161.40cm3;(2)胎盘体积与孕龄呈线性正相关,回归方程为:胎盘体积=-92.659+1.826×孕龄(d)(r=0.586,P<0.01);(3)胎盘体积与顶臀径、双顶径呈线性正相关,相关系数分别为0.276和0.377(P均<0.01)。结论:妊娠12～24周胎盘体积与孕龄具有相关性,为进一步研究胎盘体积作为FGR的预测指标奠定了基础。

Objective：To construct nomograms of placental volume according to gestational age.To study the correlation of gestational age with placental volume.To provide a basis of another investigation that placental volume will forecast FGR.Methods：From June to Dec.2009,placental volume was prospectively measured by real time 3-D ultrasonography in 516 normal pregnancies from 12 to 24 gestational weeks.The pregnant women were selected from the obstetric clinic and ward of the first affiliated hospital,Medical college,Xi＇an Jiaotong University.The age of the pregnant women was 18 to 41 years old.The average gestational age was 129.10±23.42 days（from 12＋0 weeks to 24＋6 weeks）.Inclusion criteria was healthy women,singleton pregnancies with normal fetal morphologic characteristics on ultrasonography and confirmed gestational age by first-trimester ultrasonography.Each fetus was carefully examined with Philip HDI-4000 ultrasound.Record the value of CRL,BPD,FL and the amniotic fluid.Placenta volume was measured and calculated by real time 3-D ultrasonography.Results：（1）The mean placental volume ranged from 55.61cm3 at 12 weeks to 161.40cm3 at 24 weeks.（2）Linear regression yielded the following formula for the placental volumes（PV） according to gestational age（GA）.PV（cm3）=-92.659＋1.826×GA（d）（r=0.586,P0.01）.（3）Placental volume had positive correlation with CRL and BPD.Relevance modulus was 0.276,0.377.Conclusions：Placental volume has positive relationship with gestational age during the second trimester.The study would become the basis of further investigation that the placental volume maybe forecast FGR.