Ott William J
Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, St. John's Mercy Medical Center, St. Louis, Missouri 63141, USA.
Am J Perinatol. 2002 Apr;19(3):133-7. doi: 10.1055/s-2002-25313.
The objective of this study is an attempt to evaluate the best ultrasonic method of diagnosing intrauterine growth restriction (IUGR); a retrospective study of patients with singleton pregnancies who had been scanned at the author's institution within 2 weeks of their delivery was undertaken. Estimated fetal weight, abdominal circumference, head circumference/abdominal circumference ratio, abdominal circumference/femur length ratio, and umbilical artery S/D ratio were compared for accuracy in prediction IUGR in the neonate using both univariant and multivariant statistical analysis. Five hundred one (501) patients were analyzed. One hundred fourteen (114) neonates were classified as IUGR (22.8%). Doppler evaluation of the umbilical artery showed the best sensitivity while both abdominal circumference alone and estimated fetal weight showed similar specificity, positive and negative predictive value, and lowest false-positive and -negative results. Logistic regression analysis confirmed the univariant results and showed that, when used in combination, abdominal circumference and Doppler, or estimated fetal weight and Doppler resulted in the best predictive values. Either estimated fetal weight or abdominal circumference (alone) are accurate predictors of IUGR. Combined with Doppler studies of the umbilical artery either method will provide accurate evaluation of suspected IUGR.
本研究的目的是尝试评估诊断胎儿宫内生长受限(IUGR)的最佳超声方法;对在作者所在机构分娩前2周内接受扫描的单胎妊娠患者进行了一项回顾性研究。使用单变量和多变量统计分析,比较估计胎儿体重、腹围、头围/腹围比、腹围/股骨长度比和脐动脉S/D比在预测新生儿IUGR方面的准确性。对501例患者进行了分析。114例新生儿被归类为IUGR(22.8%)。脐动脉的多普勒评估显示出最佳敏感性,而单独的腹围和估计胎儿体重显示出相似的特异性、阳性和阴性预测值,以及最低的假阳性和假阴性结果。逻辑回归分析证实了单变量结果,并表明,当联合使用时,腹围与多普勒,或估计胎儿体重与多普勒产生的预测值最佳。估计胎儿体重或腹围(单独)是IUGR的准确预测指标。结合脐动脉的多普勒研究,这两种方法都将为疑似IUGR提供准确评估。