分娩前超声检查对不同营养状况孕妇胎儿体质量估计效果

Accuracy of prenatal ultrasound examination in estimating fetal weight in pregnant women with different nutritional status

目的比较超声Hadlock法与临床公式法(袁东法)评估胎儿体质量的符合率。方法回顾分析2020年1—4月在青岛市妇女儿童医院产科住院分娩的1715例孕妇的临床资料,按孕前体质量指数(BMI)分为体质量过低(<18.5 kg/m 2)组177例、体质量正常(18.5~23.9 kg/m 2)组1118例、体质量超标(24.0~27.9 kg/m 2)组317例、肥胖(≥28.0 kg/m 2)组103例。分别应用超声Hadlock法与袁东法估测胎儿体质量,比较两种方法计算的估计胎儿体质量与实际出生体质量的差异。结果4组超声Hadlock法评估胎儿体质量的准确率均明显高于袁东法(χ2=25.212~435.840,P<0.01);Hadlock法评估胎儿体质量的准确率4组差异无统计学意义(χ2=1.392,P>0.05),袁东法评估胎儿体质量的准确率随BMI升高而降低,差异有统计学意义(χ2=59.34,P<0.01)。结论Hadlock法评估胎儿体质量的准确率明显高于袁东法,且不受孕妇孕前BMI影响。

Objective To investigatethe coincidence rate between the Hadlock ultrasound method and the clinical formula method(Yuan Dong method)in assessing estimated fetal weight(EFW).Methods A retrospective analysiswas performed for the clinical data of 1715 pregnant women who were hospitalized and gave birth in Department of Obstetrics,Qingdao Women and Children’s Hospital,from January to April 2020,and according to the body mass index(BMI)before pregnancy,they were divi-ded into underweight(BMI<18.5 kg/m 2)group with 177 women,normal weight(18.5-23.9 kg/m 2)group with 1118 women,overweight(24.0-27.9 kg/m 2)group with 317 women,and obese(≥28.0 kg/m 2)group with 103 women.Fetal weight was estimated using the Hadlock ultrasound method and the Yuan Dong method,and the two methods were compared in terms of the difference between EFW and actual birthweight.Results The Hadlock method had a significantly higher accuracy than the Yuan Dong methodin estimating fetal weight in each group(χ2=25.212-435.840,P<0.01).There was no significant difference in the accuracy of the Hadlock method in estimatingfetal weight betweenthe four groups(χ2=1.392,P>0.05),while the accuracy of the Yuan Dong method in estimating fetal weight decreased significantly with the increase in BMI(χ2=59.34,P<0.01).Conclusion The Hadlock method has a significantly higher accuracy than the Yuan Dong method in estimating fetal weight and is not affected by the BMI of pregnant women before pregnancy.