胎儿大腿中部软组织厚度：一种估计胎儿体重的新方法。

Fetal mid-thigh soft-tissue thickness: a novel method for fetal weight estimation.

作者信息

Abuelghar Wessam, Khairy Ahmed, El Bishry Gasser, Ellaithy Mohamed, Abd-Elhamid Taha

机构信息

Obstetrics and Gynecology Department, Ain Shams University, Cairo, Egypt.

出版信息

Arch Gynecol Obstet. 2014 Dec;290(6):1101-8. doi: 10.1007/s00404-014-3348-8. Epub 2014 Jul 10.

DOI:10.1007/s00404-014-3348-8

PMID:25009072

Abstract

PURPOSE

To derive a novel formula for fetal weight estimation utilizing the linear measurement of mid-thigh soft-tissue thickness (STT).

METHODS

300 women, with singleton uncomplicated pregnancy, were included in a prospective cross-sectional study. The study included four consecutive phases: phase (1) validated the original Scioscia's formula, phase (2) derived a novel modified formula for fetal weight estimation, phase (3) validated the novel modified formula, and phase (4) evaluated the agreement between the modified and original formulae.

RESULTS

A statistically significant correlation was found between actual fetal weight (AFW) and various sonographic biometric measurements including mid-thigh STT (r (2) = 0.656, p < 0.001), femur length (FL) (r (2) = 0.573, p < 0.001), bi-parietal diameter (BPD) (r (2) = 0.250, p < 0.001), abdominal circumference (AC) (r (2) = 0.310, p < 0.001), and estimated fetal weight (EFW) using the original Scioscia's formula (r (2) = 0.644, p < 0.001). The modified formula showed a better signed % difference (median = -0.41 %, IQR -1.88 to 2.03) than the original formula (median = -0.51 %, IQR -2.33 to 2.00). It was noted that, using the original formula, 88.7 % of the sample had absolute error below 5 and 98.3 % of the sample had absolute error below 10 %. On the other hand, using the modified formula, 87.3 % of the sample had absolute error below 5 %, while 97.3 % had absolute error below 10 %. The agreement between the two formulae was moderate as 134 patients out of 150 had similar ranking (κ = 0.57).

CONCLUSION

Fetal mid-thigh SST is a simple, useful, and easily applicable parameter for fetal weight estimation.

摘要

目的

利用大腿中部软组织厚度（STT）的线性测量得出一种新的胎儿体重估计公式。

方法

300名单胎无并发症妊娠的女性被纳入一项前瞻性横断面研究。该研究包括四个连续阶段：阶段（1）验证原始的乔西亚公式，阶段（2）得出一种新的改良胎儿体重估计公式，阶段（3）验证新的改良公式，阶段（4）评估改良公式与原始公式之间的一致性。

结果

发现实际胎儿体重（AFW）与包括大腿中部STT（r² = 0.656，p < 0.001）、股骨长度（FL）（r² = 0.573，p < 0.001）、双顶径（BPD）（r² = 0.250，p < 0.001）、腹围（AC）（r² = 0.310，p < 0.001）以及使用原始乔西亚公式的估计胎儿体重（EFW）（r² = 0.644，p < 0.001）在内的各种超声生物测量值之间存在统计学上的显著相关性。改良公式显示出比原始公式更好的符号化百分比差异（中位数 = -0.41%，四分位距 -1.88至2.03）（中位数 = -0.51%，四分位距 -2.33至2.00）。值得注意的是，使用原始公式时，88.7%的样本绝对误差低于5%，98.3%的样本绝对误差低于10%。另一方面，使用改良公式时，87.3%的样本绝对误差低于5%，而97.3%的样本绝对误差低于10%。两个公式之间的一致性为中等，因为150名患者中有134名具有相似的排名（κ = 0.57）。