Liverpool Women's NHS Foundation Trust, Crown St, Liverpool, L8 7SS, UK.
Best Pract Res Clin Obstet Gynaecol. 2009 Dec;23(6):833-44. doi: 10.1016/j.bpobgyn.2009.08.003. Epub 2009 Oct 6.
Foetal growth restriction is an important contributor to perinatal mortality, being responsible for up to 50% of stillbirths. Optimal prevention and accurate detection enabling timely intervention remain elusive, particularly in presumed low-risk pregnancy. Third trimester ultrasound seems a logical solution, but systematic review of evidence from randomised trials has shown that third trimester ultrasound does not have a significant impact on perinatal mortality but may increase interventions such as caesarean delivery. However, the evidence is difficult to interpret in the context of current obstetric practice as the evolution of ultrasound technology and rapid assimilation of newer techniques has resulted in questionable validity of the findings. If third trimester ultrasound were introduced routinely, there is a need to decide the optimal timing and number of examinations and what ultrasound parameters should be used to identify the foetus at risk.
胎儿生长受限是围产儿死亡的一个重要原因,占死产的比例高达 50%。最佳的预防和准确的检测并及时进行干预仍然难以实现,尤其是在假定的低风险妊娠中。孕晚期超声似乎是一个合理的解决方案,但随机试验的证据系统评价表明,孕晚期超声对围产儿死亡率没有显著影响,但可能会增加剖宫产等干预措施。然而,由于超声技术的不断发展和新技术的迅速应用,这些发现的有效性存在疑问,因此当前很难根据产科实践来解释这些证据。如果引入常规的孕晚期超声检查,就需要决定最佳的检查时间和次数,以及应该使用哪些超声参数来识别有风险的胎儿。