Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Ultrasound Obstet Gynecol. 2009 Nov;34(5):566-71. doi: 10.1002/uog.6378.
To compare the diagnostic value of fundal height and sonographically measured fetal abdominal circumference in the prediction of high and low birth weight in routine practice between 37 and 41 weeks' gestation.
Data were obtained from a multicenter study of 19 415 women in France and Belgium. In this study we included 7138 low-risk women from that population who underwent fundal height measurements no more than 8 days before delivery (Population A). We also included another 1689 women with both fundal height measurements and fetal ultrasound measurements obtained no more than 8 days before delivery (Population B). Population A was used to calculate the parameters of equations for estimating fetal weight according to fundal height alone (EFW(FH)) or fundal height in combination with other clinical indicators (EFW(FH+)). The ultrasound fetal weight estimation was based on fetal abdominal circumference (EFW(AC)) using Campbell and Wilkins' equation. The correlation between the estimated fetal weight calculated using each of the formulae and the birth weight was then evaluated in Population B, and the diagnostic value of each of the methods for predicting birth weight <or=2500 g or >or=4000 g was also compared.
EFW(AC) was better correlated with birth weight than was either EFW(FH) or EFW(FH+). With specificity set at 95%, the sensitivity of EFW(AC) in screening for neonates weighing <or=2500 g was significantly higher than that of EFW(FH) (50.7% vs. 41.2%, P < 0.05) or EFW(FH+) (50.7% vs. 40.4%, P < 0.05). Similarly, its sensitivity for predicting a birth weight of >or=4000 g was significantly higher than that of EFW(FH) (54.0% vs. 37.1%, P < 0.05) or EFW(FH+) (54.0% vs. 45.1%, P < 0.05).
Sonographic measurement of fetal abdominal circumference predicts high and low birth weight better than does clinical examination based on fundal height in routine practice between 37 and 41 weeks' gestation.
比较经腹部超声测量胎儿腹围与宫底高度在预测 37 至 41 孕周常规产检孕妇中胎儿低出生体重与高出生体重的诊断价值。
数据来源于法国和比利时的一项多中心研究，共纳入 19415 例低危孕妇，其中 7138 例孕妇在分娩前 8 天内仅行宫底高度测量（A 人群），另 1689 例孕妇在分娩前 8 天内行宫底高度和胎儿超声测量（B 人群）。A 人群用于计算仅根据宫底高度（EFW（FH））或宫底高度联合其他临床指标（EFW（FH+））估计胎儿体重的方程参数。超声胎儿体重估测采用 Campbell 和 Wilkins 公式，根据胎儿腹围（EFW（AC））进行计算。然后在 B 人群中评估各公式计算的估计胎儿体重与出生体重的相关性，并比较各方法预测出生体重<2500 g 或>4000 g 的诊断价值。
EFW（AC）与出生体重的相关性优于 EFW（FH）或 EFW（FH+）。在特异性为 95%的情况下，EFW（AC）筛查<2500 g 出生体重的敏感性明显高于 EFW（FH）（50.7%比 41.2%，P<0.05）或 EFW（FH+）（50.7%比 40.4%，P<0.05）。同样，EFW（AC）预测出生体重>4000 g 的敏感性也明显高于 EFW（FH）（54.0%比 37.1%，P<0.05）或 EFW（FH+）（54.0%比 45.1%，P<0.05）。
在 37 至 41 孕周常规产检中，与基于宫底高度的临床检查相比，经腹部超声测量胎儿腹围更能准确预测胎儿低出生体重与高出生体重。
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