探讨胎儿腹围在预测巨大儿评估中的临床价值

Analysis the clinical value of fetal abdominal circumference in predicting macrosomia

目的评估胎儿腹围在预测巨大儿评估中的临床价值。方法对2017年3月至2019年2月在陕西省第二人民医院产科妊娠37~42周分娩的1107例孕妇病例资料进行回顾性分析,判断超声检测胎儿生长发育指标与新生儿出生体重之间的相关性,观察胎儿腹围在预测巨大儿评估中的临床价值,并比较以胎儿腹围及Hadlock公式预测巨大儿的统计学意义。结果胎儿腹围、双顶径及股骨长度与新生儿出生体重呈正相关。其中胎儿腹围与新生儿出生体重的相关性最大(r=0.93,P<0.001),其次为股骨长及双顶径(r=0.73,P<0.001,r=0.72,P<0.001)。胎儿腹围预测巨大儿的临床最佳临界值为35.8 cm(约登指数为0.79)。通过测量胎儿腹围或Hadlock公式的方式预测巨大儿,差异无统计学意义。结论采用超声检测判断胎儿腹围,可实现对巨大儿风险的预测。较Hadlock公式相比,超声检测相对便利,操作简单,临床应用价值显著。

Objective To assess the reliability of ultrasonic fetal biometrics in estimating fetal birth weight.Methods Retrospective data of pregnancy delivered between 37-42 weeks of gestation were collected.A total of 1107 samples were enrolled.The study variables included the fetal biparietal diameter,abdominal circumference and femur length,and pregnant outcomes.Linear models were fitted to find relationship between fetal biometry and birth weight.Results Linear relationship between fetal biometric measurements and birth weight was identified.Significant correlations were identified between birth weight and fetal abdominal circumference(r=0.93,P<0.001),femur length(r=0.73 P<0.001)and biparietal diameter(r=0.72 P<0.001).The optimal clinical critical value of fetal abdominal circumference for predicting macrosomia was 35.8 cm(Youden index=0.79).No significant difference was found between the fetal abdominal circumference and Hadlock formula in prediction of macrosomia.Conclusion Fetal abdominal circumference is an efficient index in estimating birth weight and predicting macrosomia.