Department of Obstetrics and Gynecology, Mannheim University Hospital, Universitätsfrauenklinik, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Arch Gynecol Obstet. 2011 Dec;284(6):1345-9. doi: 10.1007/s00404-011-1888-8. Epub 2011 Mar 23.
To evaluate the potential of fetal abdominal circumference (AC) measurement as predictor of perinatal complications in term newborns.
This prospective study included 324 consecutive term pregnancies within a 6-month period between February and August 2009. Inclusion criteria were a singleton pregnancy with at least 37 weeks of gestation, vertex presentation, absence of structural or chromosomal disorders and complete ultrasound examination within 3 days of delivery. Patients with elective caesarean sections were excluded. Vaginal deliveries were assessed with regard to the impact of fetal AC on the mode of delivery, the neonatal outcome (pH, base excess, APGAR score at 5 min) and the incidence of perineal injuries. When appropriate, U tests and χ (2) tests were performed for group comparisons.
Complete data were obtained for 258 patients. Sixty-six patients were excluded because they underwent elective caesarean section. Only 12 of the 30 fetuses with an AC ≥ 36.0 cm weighed more than 4,000 g. There was no significant difference in relation to incidence of surgical delivery (instrumental delivery, P = 0.754 and caesarean section, P = 0.405), the neonatal outcome (pH, P = 0.527; base excess, P = 0.146; APGAR score at 5 min, P = 0.552), and the occurrence of perineal injuries (2nd and 3rd degree, P = 0.951).
The results of the study could not demonstrate a significant relationship between AC ≥ 36.0 cm and perinatal complications. For this, measuring the fetal AC is of no help in finding the correct clinical management.
评估胎儿腹围(AC)测量作为预测足月新生儿围产并发症的潜力。
这是一项前瞻性研究,纳入了 2009 年 2 月至 8 月期间连续 324 例足月妊娠。纳入标准为单胎妊娠,至少 37 周妊娠,头位,无结构或染色体异常,分娩后 3 天内完成完整的超声检查。排除选择性剖宫产患者。阴道分娩评估胎儿 AC 对分娩方式、新生儿结局(pH 值、碱剩余、5 分钟时 APGAR 评分)和会阴损伤发生率的影响。适当情况下,采用 U 检验和 χ²检验进行组间比较。
258 例患者获得完整数据。66 例因选择性剖宫产而被排除。仅 30 例 AC≥36.0cm 的胎儿中有 12 例体重超过 4000g。在手术分娩(器械分娩,P=0.754;剖宫产,P=0.405)、新生儿结局(pH 值,P=0.527;碱剩余,P=0.146;5 分钟时 APGAR 评分,P=0.552)和会阴损伤发生率(2 度和 3 度,P=0.951)方面无显著差异。
研究结果未能显示 AC≥36.0cm 与围产并发症之间存在显著关系。因此,测量胎儿 AC 无助于找到正确的临床管理方法。