Haragan Adriane F, Hulsey Thomas C, Hawk Angela F, Newman Roger B, Chang Eugene Y
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC.
West Virginia University School of Public Health, Morgantown, WV.
Am J Obstet Gynecol. 2015 Jun;212(6):820.e1-8. doi: 10.1016/j.ajog.2015.03.042. Epub 2015 Mar 25.
We sought to compare fundal height and handheld ultrasound-measured fetal abdominal circumference (HHAC) for the prediction of fetal growth restriction (FGR) or large for gestational age.
This was a diagnostic accuracy study in nonanomalous singleton pregnancies between 24 and 40 weeks' gestation. Patients underwent HHAC and fundal height measurement prior to formal growth ultrasound. FGR was defined as estimated fetal weight less than 10%, whereas large for gestational age was defined as estimated fetal weight greater than 90%. Sensitivity and specificity were calculated and compared using methods described elsewhere.
There were 251 patients included in this study. HHAC had superior sensitivity and specificity for the detection of FGR (sensitivity, 100% vs 42.86%) and (specificity, 92.62% vs 85.24%). HHAC had higher specificity but lower sensitivity when screening for LGA (specificity, 85.66% vs 66.39%) and (sensitivity, 57.14% vs 71.43%).
HHAC could prove to be a valuable screening tool in the detection of FGR. Further studies are needed in a larger population.
我们试图比较宫高和手持超声测量的胎儿腹围（HHAC）对胎儿生长受限（FGR）或大于胎龄儿的预测价值。
这是一项针对妊娠24至40周的非畸形单胎妊娠的诊断准确性研究。患者在进行正式的生长超声检查前接受HHAC和宫高测量。FGR定义为估计胎儿体重小于第10百分位数，而大于胎龄儿定义为估计胎儿体重大于第90百分位数。使用其他地方描述的方法计算并比较敏感性和特异性。
本研究纳入了251例患者。HHAC在检测FGR方面具有更高的敏感性和特异性（敏感性，100%对42.86%）以及（特异性，92.62%对85.24%）。在筛查大于胎龄儿时，HHAC具有更高的特异性但更低的敏感性（特异性，85.66%对66.39%）以及（敏感性，57.14%对71.43%）。
HHAC可能被证明是检测FGR的一种有价值的筛查工具。需要在更大的人群中进行进一步研究。
