von Kaisenberg C S, Fritzer E, Kühling H, Jonat W
Department of Obstetrics and Gynecology, University of Kiel, Germany.
Ultrasound Obstet Gynecol. 2002 Dec;20(6):564-74. doi: 10.1046/j.1469-0705.2002.00842.x.
To establish comprehensive transabdominal ultrasonographic reference ranges for viable normal singleton human fetuses at 11-14 weeks' gestation.
Single transabdominal ultrasound measurements were taken once per pregnancy at a gestational age of between 11+0 and 14+0 weeks (crown-rump length, 45-84 mm), in viable singleton fetuses with nuchal translucency < or = 3 mm and without detectable structural anomalies, using four standard planes: (i) biparietal diameter (BPD) and fronto-occipital diameter (FOD) resulting in head circumference (HC), anterior horn (Va), posterior horn (Vp), and hemisphere (HEM); (ii) transcerebellar diameter (TCD) and cisterna magna (CM); (iii) abdominal anteroposterior (AAP) and abdominal transverse diameter (ATD) resulting in abdominal circumference (AC); and (iv) femur length (FL). The respective ratios Va/HEM, Vp/HEM, HC/AC, BPD/FL, BPD/FOD, FL/CRL, FL/BPD and FL/AC and the estimated weight were derived. Reference ranges were constructed and the mean and 5th and 95th centiles were plotted against gestation.
There was a general increase in biometric parameters with gestation. The ratios for the ventricles vs. hemisphere and BPD/FL ratio decreased while the BPD/FOD and HC/AC ratios remained constant. Analysis of the reference range for BPD/FL was performed in both 167 and 664 fetuses and the results showed almost the identical type of equation, indicating a high degree of accuracy for the growth charts.
We have established comprehensive reference ranges for first-trimester fetal biometry by transabdominal sonography. These charts may have a role in the diagnosis of early onset symmetrical or asymmetrical growth restriction and in the interpretation of measurements in chromosomally abnormal fetuses, and they may help in the detection of skeletal dysplasias or acrania/anencephaly.
建立孕11 - 14周存活的正常单胎妊娠胎儿经腹超声检查的综合参考范围。
对孕龄在11⁺⁰至14⁺⁰周（头臀长45 - 84毫米）、颈部透明带≤3毫米且无可检测到的结构异常的存活单胎胎儿，每次妊娠进行一次经腹超声测量，使用四个标准平面：（i）双顶径（BPD）和额枕径（FOD）得出头围（HC）、前角（Va）、后角（Vp）和半球（HEM）；（ii）小脑横径（TCD）和枕大池（CM）；（iii）腹前后径（AAP）和腹横径（ATD）得出腹围（AC）；（iv）股骨长度（FL）。得出各自的Va/HEM、Vp/HEM、HC/AC、BPD/FL、BPD/FOD、FL/CRL、FL/BPD和FL/AC比值以及估计体重。构建参考范围，并将均值、第5和第95百分位数与孕周作图。
随着孕周增加，生物测量参数总体上升。脑室与半球的比值以及BPD/FL比值下降，而BPD/FOD和HC/AC比值保持不变。对167例和664例胎儿进行了BPD/FL参考范围分析，结果显示方程类型几乎相同，表明生长图表具有高度准确性。
我们通过经腹超声建立了孕早期胎儿生物测量的综合参考范围。这些图表可能在早发型对称或不对称生长受限的诊断以及染色体异常胎儿测量结果的解释中发挥作用，并且可能有助于检测骨骼发育异常或无脑儿/无脑畸形。
