Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599-7516, USA.
Am J Perinatol. 2010 Mar;27(3):211-7. doi: 10.1055/s-0029-1236440. Epub 2009 Aug 17.
The objective of this study was to evaluate patterns of intrauterine growth in fetal gastroschisis. This was a retrospective review of prenatally diagnosed cases of fetal gastroschisis delivered at the University of North Carolina Hospital from January 2000 to January 2007. Fetal growth (biparietal diameter, head circumference, abdominal circumference, femur length, and estimated fetal weight) and amniotic fluid volume were evaluated by gestational age. Gastroschisis was diagnosed in 83 pregnancies; outcomes were available in 71 fetuses. The mean gestational age at diagnosis was 17 weeks and 1 day. The mean gestational age at delivery was 35 weeks and 4 days. Mean birth weight was 2306 g. As early as the second trimester, all morphometric measures demonstrated impaired in utero growth, with growth curves shifted to the right of the 50th percentile when compared with a standard population. Estimated fetal weight below the 10th percentile was suspected in 23% of pregnancies, and birth weight at less than the 10th percentile occurred in 47% of neonates. Amniotic fluid volumes remained stable throughout gestation. Fetuses with gastroschisis display impaired intrauterine growth, which is noted in the midsecond trimester of pregnancy and does not appear to progress throughout gestation.
本研究旨在评估胎儿先天性腹壁裂的宫内生长模式。这是一项回顾性研究,分析了 2000 年 1 月至 2007 年 1 月期间在北卡罗来纳大学医院分娩的产前诊断为胎儿先天性腹壁裂的病例。通过胎龄评估胎儿生长情况(双顶径、头围、腹围、股骨长和估计胎儿体重)和羊水体积。83 例妊娠中诊断出先天性腹壁裂,71 例胎儿结局可用。诊断时的平均胎龄为 17 周 1 天,分娩时的平均胎龄为 35 周 4 天,平均出生体重为 2306 克。早在妊娠中期,所有的形态测量指标均显示宫内生长受损,与标准人群相比,生长曲线向右偏移至第 50 百分位数。23%的妊娠被怀疑胎儿体重低于第 10 百分位数,47%的新生儿出生体重低于第 10 百分位数。整个妊娠期间羊水体积保持稳定。患有先天性腹壁裂的胎儿表现出宫内生长受损,这种情况在妊娠中期就已经出现,而且似乎不会随着妊娠进展而继续发展。