对比不同超声估重公式预测巨大胎儿体质量

Comparison on different sonographic fetal weight estimate formulas for predicting fetal macrosomia's mass

目的观察不同超声估重(SFEW)公式预测巨大胎儿的准确率,分析其影响因素。方法回顾629例巨大儿,根据体质量分为A组和B组;将产前超声所测双顶径(BPD)、头围(HC)、腹围(AC)及股骨长(FL)代入不同公式,比较SFEW预测值与出生后实测值的差异。结果不同估算公式SFEW测值均明显低于实测值(P均<0.001),其中Hadlock公式预测值与实测值的差异最小;产前超声生物学测值与出生后实测体质量及身长低度相关(rs<0.50)。B组身长、体质量指数(BMI)及各超声生物学测值均明显大于A组(P均<0.05);不同公式计算B组误差均明显大于A组(P均<0.05)。结论 SFEW有效可行,但易低估胎儿体质量,各公式参数不能充分体现巨大胎儿躯干外脂肪分布差异对体质量的影响可能是原因之一。

Objective To compare the accuracy of different sonographic fetal weight estimate(SFEW)formulas in predicting fetal macrosomia's mass,and to analyze the impact factors.Methods Data of 629 cases of macrosomia were retrospectively analyzed.The macrosomia were divided into group A and group B according to actual masses after delivery.The biparietal diameter(BPD),head circumference(HC),abdominal circumference(AC)and femur length(FL)were substituted into different formulas to compare the predicting values of fetal macrosomia and the actually measured values.Results SFEW calculated with different estimation formulas were all significantly lower than the measured values(all P<0.001).The difference of the predicted value and the measured value of Hadlock formula taken BPD,AC and FL as parameters was the smallest.There were low correlation between the biological values of ultrasound of fetal macrosomia and the measured mass and length(r s<0.50).Body length,body mass index(BMI)and all biological values of group B were higher than those of group A(all P<0.05).Error of different formulas in group B were higher than those in group A(P<0.05).Conclusion SFEW was effective and feasible to predict fetal macrosomia,but tended to underestimate fetal mass.Parameters used in formulas which could not fully reflect the impact of fat distribution outside body trunk of fetal macrosomia might be one of the causes.