[使用头围、腹围和股骨长度进行超声胎儿体重估计的准确性]

Mladenović-Segedi Ljiljana, Segedi Dimitrije

Klinicki centar Novi Sad, Klinika za ginekologiju i akuserstvo.

Med Pregl. 2005 Nov-Dec;58(11-12):548-52. doi: 10.2298/mpns0512548m.

INTRODUCTION

Former investigations have shown that the accuracy of fetal weight estimation is significantly higher if several ultrasonic fetal parameters are measured, because the total body mass depends on the size of fetal head, abdominal circumference and femur length. The aim of this investigation was to establish the best regression model, that is a number of combinations of fetal parameters providing the most accurate fetal weight estimation in utero in our population.

MATERIAL AND METHODS

This prospective study was carried out at the Gynecology and Obstetrics Clinic of the Clinical Center Novi Sad. It included 270 pregnant women with singleton pregnancies within 72 hours of delivery who underwent ultrasound measurements of the biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL).

RESULTS

In regard to fetal weight estimation formulas, the deviation was lowest using regression models that simultaneously analyzed four fetal parameters (0. 55%) with SD +/- 7.61%. In these models the estimates of fetal weights were within +/- 5% of actual birth weight in 48.89%, and within +/- 10% of actual birth weight in 81.48%. Good results were also obtained using AC, FL measurements (0.92% +/- 8.20) as well as using AC, HC, FL measurements (-1.45% +/- 7.81). In our sample the combination of AC and FL model gave better results in fetal weight estimation (0.92 +/- 8.20%) than the one using BPD and AC (2.97 +/- 8.83%). Furthermore, the model using parameters AC, HC and FL showed a lower error in accuracy (-1.45 +/- 7.81%) than the model using BPD, AC and FL (2.51 +/- 7.82%).

CONCLUSION

This investigation has confirmed that the accuracy of fetal weight estimation increases with the number of measured ultrasonic fetal parameters. In our population the greatest accuracy was obtained using BPD, HC, AC and FL model. In cases when fast estimation of fetal weight is needed, AC, HC, FL model may be appropriate, but if fetal head circumference cannot be measured (amnion rupture and/or fetal head already in the pelvis) the AC, FL model should be used.

引言

先前的研究表明，如果测量多个超声胎儿参数，胎儿体重估计的准确性会显著提高，因为总体重取决于胎儿头部大小、腹围和股骨长度。本研究的目的是建立最佳回归模型，即在我们的人群中，确定能提供最准确的子宫内胎儿体重估计的多个胎儿参数组合。

材料与方法

这项前瞻性研究在诺维萨德临床中心的妇产科诊所进行。研究对象包括270名单胎妊娠孕妇，她们在分娩前72小时内接受了双顶径（BPD）、头围（HC）、腹围（AC）和股骨长度（FL）的超声测量。

结果

关于胎儿体重估计公式，使用同时分析四个胎儿参数的回归模型时偏差最低（0.55%），标准差为±7.61%。在这些模型中，48.89%的胎儿体重估计值在实际出生体重的±5%范围内，81.48%在实际出生体重的±10%范围内。使用AC、FL测量（0.92%±8.20）以及使用AC、HC、FL测量（-1.45%±7.81）也取得了良好结果。在我们的样本中，AC和FL模型在胎儿体重估计方面比使用BPD和AC的模型（2.97%±8.83%）效果更好。此外，使用参数AC、HC和FL的模型在准确性方面的误差（-1.45±7.81%）低于使用BPD、AC和FL的模型（2.51±7.82%）。