超声测量胎儿腹围预测巨大儿的可行性研究

Study on ultrasound measurements of fetal abdominal circumference predicting macrosomic infants

目的 探讨超声测量胎儿腹围预测巨大儿的可行性。 方法 对1077名孕龄在36周以上、单胎、且产前7天内进行过超声检查的资料回顾性研究。以胎儿腹围的超声测值评价预测巨大儿的价值。 结果 有394例胎儿腹围大于等于35厘米,其中68例出生体重大于等于4000克。在鉴别巨大儿方面,其敏感性为93.15％,特异性为67.53％;有23例胎儿腹围大于等于38厘米,其中21例出生体重大于等于4000克,如以38厘米腹围为标准,则敏感性为28.77％,特异性为99.80％。 结论 超声测量胎儿腹围可鉴别巨大儿,了解胎儿腹围测量的两个界值(35CM,38CM)有助于临床医生避免或处理如肩难产等与巨大儿相关的产科问题。

Objective To determine if ultrasound measurements of fetal abdominal circumference (AC) can be used to predict macrosomic infants. Methods 1077 women at 2≥36 weeks' gestation, delivering a singleton infant and having an ultrasound examination within one week of delivery were studied. Fetal AC was evaluated to determine if it was useful in predicting the birth of a macrosomic infant, ≥4000g. Results AC of 5≥35cm occurred in 394 of the infants, including 68 of 73 infants &4000g. This AC value had a sensitivity of 93.14%. The specificity was only 67.53%. AC of ≥38cm occurred in 23 of the infants, including 21 of 73 infants 3≥4000g. This AC value had a sensitivi-ty of 28.77%, but the specificity of 99.80%. Conclusion Fetal AC is of great benefit to identify potential macrosomic infants. Fetal AC measurements of 35 and 38 cm have useful predictive value in helping to avoid and manage shoulder dystocia of having a macrosomic infant.