根据末次月经估算为过期妊娠，但根据超声估算并非过期妊娠的孕妇的胎儿结局。
Fetal outcome in pregnancies defined as post-term according to the last menstrual period estimate, but not according to the ultrasound estimate.
作者信息
Tunón K, Eik-Nes S H, Grøttum P
机构信息
Department of Obstetrics and Gynecology, Trondheim University Hospital, Norway.
出版信息
Ultrasound Obstet Gynecol. 1999 Jul;14(1):12-6. doi: 10.1046/j.1469-0705.1999.14010012.x.
OBJECTIVE
To study the risk of adverse fetal outcome in fetuses that were post-term according to the last menstrual period estimate but not according to the ultrasound estimate.
DESIGN
A total of 11,510 women with singleton pregnancies, reliable last menstrual period and delivery after 37 weeks were divided into four groups: women who delivered at term, i.e. within 259-295 days according to both the ultrasound and the last menstrual period estimate; women who delivered post-term according to the last menstrual period estimate but not according to the ultrasound estimate; women who delivered post-term according to the ultrasound estimate but not according to the last menstrual period estimate; and women who delivered post-term according to both the ultrasound and the last menstrual period estimates. Stepwise logistic regression was used to test whether the risk of Apgar score of < 7 after 5 min and transfer to the neonatal intensive care unit increased in any of the post-term groups.
RESULTS
There was no significant difference in mortality between the term group and the three study groups. There was no significant increase in the risk for Apgar score of < 7 after 5 min or transfer to the neonatal intensive care unit for pregnancies that were defined as post-term according to the last menstrual period estimate but not according to the ultrasound estimate. There was, however, an increased risk for Apgar score of < 7 after 5 min in the group that was post-term according to the ultrasound estimate but not according to the last menstrual period estimate. There was also an increased risk for transfer to the neonatal intensive care unit in the group that was post-term according to both estimates.
CONCLUSION
The effect of ultrasound in changing the estimated day of delivery to a later date leading to pregnancies becoming post-term according to the last menstrual period estimate but not according to the ultrasound estimate does not have any adverse consequences for the fetal outcome. However, there seems to be an increased risk for adverse consequences for pregnancies that are post-term according to the ultrasound estimate.
目的
研究根据末次月经估算为过期妊娠但根据超声估算并非过期妊娠的胎儿出现不良结局的风险。
设计
总共11510名单胎妊娠、末次月经可靠且在37周后分娩的女性被分为四组：足月分娩的女性，即根据超声和末次月经估算均在259 - 295天内分娩的女性；根据末次月经估算为过期妊娠但根据超声估算并非过期妊娠的女性；根据超声估算为过期妊娠但根据末次月经估算并非过期妊娠的女性；以及根据超声和末次月经估算均为过期妊娠的女性。采用逐步逻辑回归分析来检验任何过期妊娠组中5分钟后阿氏评分<7分以及转入新生儿重症监护病房的风险是否增加。
结果
足月组与三个研究组之间的死亡率无显著差异。根据末次月经估算为过期妊娠但根据超声估算并非过期妊娠的妊娠，5分钟后阿氏评分<7分或转入新生儿重症监护病房的风险没有显著增加。然而，根据超声估算为过期妊娠但根据末次月经估算并非过期妊娠的组中，5分钟后阿氏评分<7分的风险增加。根据两种估算均为过期妊娠的组中，转入新生儿重症监护病房的风险也增加。
结论
超声将预计分娩日期推迟，导致根据末次月经估算为过期妊娠但根据超声估算并非过期妊娠，这对胎儿结局没有任何不良影响。然而，根据超声估算为过期妊娠的妊娠似乎出现不良后果的风险增加。
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