Bethune M, Bell R
Ultrasound Department, Royal Women's Hospital, Melbourne, Australia.
Ultrasound Obstet Gynecol. 2003 Dec;22(6):586-90. doi: 10.1002/uog.885.
To evaluate the measurement of the fetal abdominal fat layer (FFL), cardiac interventricular septum (IVS) and abdominal circumference (AC) percentile in the early third trimester as predictors of macrosomia at birth in the fetuses of women with gestational diabetes.
Ninety patients attending the hospital's special diabetic clinic were recruited prospectively. FFL and IVS were measured in addition to the routine biometry in the early third trimester. AC was measured routinely and AC percentile was determined from established antenatal charts. These measurements were then assessed as predictors of macrosomia.
A fetal fat layer of >/=5 mm was the most useful predictor of macrosomia at term as assessed using the likelihood ratio. An AC >/=90th percentile, however, had a better sensitivity.
The usefulness of routine FFL measurement in the early third trimester in the management of diabetic pregnancies is worthy of further evaluation.
评估孕晚期早期胎儿腹部脂肪层(FFL)、心脏室间隔(IVS)及腹围(AC)百分位数作为妊娠期糖尿病孕妇胎儿出生时巨大儿预测指标的价值。
前瞻性招募90名到医院糖尿病专科门诊就诊的患者。在孕晚期早期,除了常规生物测量外,还测量了FFL和IVS。常规测量AC,并根据既定的产前图表确定AC百分位数。然后将这些测量结果作为巨大儿的预测指标进行评估。
使用似然比评估,胎儿脂肪层厚度≥5 mm是足月巨大儿最有用的预测指标。然而,AC≥第90百分位数具有更好的敏感性。
孕晚期早期常规测量FFL在糖尿病妊娠管理中的作用值得进一步评估。