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孕期测量耻骨联合上子宫高度(SFH)以检测胎儿生长异常。

Symphysial fundal height (SFH) measurement in pregnancy for detecting abnormal fetal growth.

作者信息

Robert Peter Japaraj, Ho Jacqueline J, Valliapan Jayabalan, Sivasangari Subramaniam

机构信息

Department of Obstetrics and Gynecology, Ipoh Hospital, Ipoh, Malaysia.

出版信息

Cochrane Database Syst Rev. 2012 Jul 11(7):CD008136. doi: 10.1002/14651858.CD008136.pub2.

Abstract

BACKGROUND

Symphysis fundal height (SFH) measurement is commonly practiced primarily to detect fetal intrauterine growth restriction (IUGR). Undiagnosed IUGR may lead to fetal death as well as increase perinatal mortality and morbidity.

OBJECTIVES

The objective of this review is to compare SFH measurement with serial ultrasound measurement of fetal parameters or clinical palpation to detect abnormal fetal growth (IUGR and large-for-gestational age), and improving perinatal outcome.

SEARCH METHODS

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (20 January 2012) and reference lists of retrieved articles.

SELECTION CRITERIA

Randomised controlled trials including quasi-randomised and cluster-randomised trials involving pregnant women with singleton fetuses at 20 weeks' gestation and above comparing tape measurement of SFH with serial ultrasound measurement of fetal parameters or clinical palpation using anatomical landmarks.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed trials for inclusion, trial quality and extracted data. Data were checked for accuracy.

MAIN RESULTS

One trial involving 1639 women was included. It compared SFH measurement with clinical abdominal palpation.There was no difference in the two reported primary outcomes of incidence of small-for-gestational age (risk ratio (RR) 1.32; 95% confidence interval (CI) 0.92 to 1.90) or perinatal death. There was no difference in the reported secondary outcomes of neonatal hypoglycaemia, admission to neonatal nursery, admission to the neonatal nursery for IUGR, induction of labour and caesarean section.

AUTHORS' CONCLUSIONS: There is insufficient evidence to determine whether SFH measurement is effective in detecting IUGR. We cannot therefore recommended any change of current practice. Further trials are needed.

摘要

背景

宫底高度(SFH)测量主要用于检测胎儿宫内生长受限(IUGR)。未诊断出的IUGR可能导致胎儿死亡,并增加围产期死亡率和发病率。

目的

本综述的目的是比较SFH测量与胎儿参数的系列超声测量或临床触诊,以检测胎儿生长异常(IUGR和大于胎龄儿),并改善围产期结局。

检索方法

我们检索了Cochrane妊娠与分娩组试验注册库(2012年1月20日)以及检索到的文章的参考文献列表。

入选标准

随机对照试验,包括半随机和整群随机试验,涉及妊娠20周及以上的单胎孕妇,比较SFH卷尺测量与胎儿参数的系列超声测量或使用解剖标志的临床触诊。

数据收集与分析

两位综述作者独立评估试验是否纳入、试验质量并提取数据。检查数据的准确性。

主要结果

纳入了一项涉及1639名女性的试验。该试验比较了SFH测量与临床腹部触诊。在小于胎龄儿发病率(风险比(RR)1.32;95%置信区间(CI)0.92至1.90)或围产期死亡这两个报告的主要结局方面没有差异。在报告的次要结局方面,如新生儿低血糖、入住新生儿重症监护室、因IUGR入住新生儿重症监护室、引产和剖宫产方面也没有差异。

作者结论

没有足够的证据来确定SFH测量在检测IUGR方面是否有效。因此,我们不能建议改变当前做法。需要进一步的试验。

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