Deter R L, Stefos T, Harrist R B, Hill R M
Department of Obstetrics/Gynecology, Baylor College of Medicine, Houston, Texas 77030.
J Clin Ultrasound. 1992 Nov-Dec;20(9):573-7. doi: 10.1002/jcu.1870200902.
The growth of 17 sets of twins was evaluated at 2 to 3 week intervals from 15 weeks to delivery by measurement of the head circumference, abdominal circumference, and thigh circumference, and estimation of weight. The birth characteristics of these twins were compared to those predicted by Rossavik growth models, derived from second-trimester ultrasound measurements, using the Growth Potential Realization Index (GPRI) and by comparison to population standards. Newborns were classified as normal or intrauterine growth retarded (IUGR) based on their Neonatal Growth Assessment Score, determined from GPRI values. All normal twins had birth weights that were appropriate-for-gestational-age and had few abnormal birth measurements. The birth weight differences between normal twin fetuses were all < 20%. IUGR twins were both small for gestational age (78%) and appropriate-for-gestational-age (22%), and all had 3 or 4 abnormal GPRI values. In only 40% of the cases was the birth-weight difference between a normal and an IUGR twin > 20%. No single anatomic parameter evaluated at birth adequately separated the normal twins from those with IUGR. These results indicate the need for multiple parameter Individualized Growth Assessment in the detection of IUGR in twins.
从孕15周直至分娩，每隔2至3周对17对双胞胎的生长情况进行评估，测量其头围、腹围和大腿围，并估算体重。使用生长潜力实现指数（GPRI），将这些双胞胎的出生特征与基于孕中期超声测量得出的罗萨维克生长模型所预测的特征进行比较，并与群体标准进行比较。根据由GPRI值确定的新生儿生长评估分数，将新生儿分为正常或宫内生长受限（IUGR）。所有正常双胞胎的出生体重均为适于胎龄，且出生测量异常情况较少。正常双胞胎胎儿之间的出生体重差异均<20%。IUGR双胞胎既有小于胎龄儿（78%），也有适于胎龄儿（22%），且所有IUGR双胞胎均有3个或4个GPRI异常值。在仅40%的病例中，正常双胞胎与IUGR双胞胎之间的出生体重差异>20%。出生时评估的任何单一解剖学参数均无法充分区分正常双胞胎与IUGR双胞胎。这些结果表明，在检测双胞胎的IUGR时，需要进行多参数个体化生长评估。
