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分娩期超声测量胎儿腹围预测巨大儿

Intrapartum fetal abdominal circumference by ultrasonography for predicting fetal macrosomia.

作者信息

Loetworawanit Ratchanikon, Chittacharoen Apichart, Sututvoravut Somsak

机构信息

Department of Obstetrics and Gynecology Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.

出版信息

J Med Assoc Thai. 2006 Oct;89 Suppl 4:S60-4.

Abstract

OBJECTIVE

To evaluate the diagnostic value of sonographic measurement of fetal abdominal circumference (AC) for the prediction of fetal macrosomia.

MATERIAL AND METHOD

A prospective clinical trial was conducted at Department of Obstetrics and Gynecology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. The study consisted of 361 singleton pregnant women who were admitted for delivery at labor room. All women underwent sonographic measurements of the fetal abdominal circumference (AC) during the early intrapartum period. The AC values were correlated to actual fetal birth weight. The cut-off value of AC for predicting of fetal macrosomia was analyzed.

RESULTS

Among 361 cases, the mean maternal age was 29.0 +/- 5.5 years (range, 15-46). The median gestational age was 39 weeks (range, 31-42). The mean fetal birth weight was 3,179.83 +/- 450.91 gm (range, 1,180-4,560). The prevalence of macrosomia was 11.08% (40/361). A cut-off value of abdominal circumference > or = 35 cm was the best predicting of fetal macrosomia. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 87.50%, 84.74%, 85.04%, 41.67%, and 98.19%, respectively.

CONCLUSION

The intrapartum fetal AC measurement was useful in predicting of fetal macrosomia. An AC measurement of > or = 35 cm was the best value of fetal macrosomia prediction.

摘要

目的

评估超声测量胎儿腹围(AC)对预测巨大儿的诊断价值。

材料与方法

在泰国曼谷玛希隆大学拉玛提波迪医院妇产科进行了一项前瞻性临床试验。该研究包括361名单胎孕妇,她们在产房入院分娩。所有孕妇在产程早期均接受了胎儿腹围(AC)的超声测量。将AC值与实际胎儿出生体重进行相关性分析。分析预测巨大儿的AC临界值。

结果

361例中,孕妇平均年龄为29.0±5.5岁(范围15 - 46岁)。中位孕周为39周(范围31 - 42周)。胎儿平均出生体重为3179.83±450.91克(范围1180 - 4560克)。巨大儿发生率为11.08%(40/361)。腹围≥35 cm的临界值对胎儿巨大儿的预测最佳。其敏感性、特异性、准确性、阳性预测值和阴性预测值分别为87.50%、84.74%、85.04%、41.67%和98.19%。

结论

产程中测量胎儿AC对预测巨大儿有用。AC测量值≥35 cm是预测胎儿巨大儿的最佳值。

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