Ergaz Udi, Goldstein Israel, Divon Michael, Weiner Zeev
Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel; ; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel;
Department of Obstetrics and Gynecology, Lenox Hill hospital, New York, NY, USA.
Rambam Maimonides Med J. 2015 Apr 29;6(2):e0019. doi: 10.5041/RMMJ.10203. eCollection 2015 Apr.
This study was aimed at establishing an ideal method for performing three-dimensional measurements of the fetus in order to improve the estimation of fetal weight.
The study consisted of two phases. Phase I was a prospective cross-sectional study performed between 28 and 40 weeks' gestation. The study population (n=110) comprised low-risk singleton pregnancies who underwent a routine third-trimester sonographic estimation of fetal weight. The purpose of this phase was to establish normal values for the fetal abdominal and head volumes throughout the third trimester. Phase II was a prospective study that included patients admitted for an elective cesarean section or for induction of labor between 38 and 41 weeks' gestation (n=91). This phase of the study compared the actual birth weight to two- (2D) and three-dimensional (3D) measurements of the fetus. Conventional 2D ultrasound fetal biometry was performed measuring the biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur diaphysis length (FL). Volume estimates were computed utilizing Virtual Organ Computer-aided AnaLysis (VOCAL), and the correlation between measured volumes and actual neonatal weight was calculated.
Overall, this longitudinal study consisted of 110 patients between 28 and 41 weeks' gestation. Normal values were computed for the fetal abdomen and head volume throughout the third trimester. Ultrasound examination was performed within three days prior to delivery on 91 patients. A good correlation was found between birth weight and abdominal volume (r=0.77) and between birth weight and head volume (r=0.5). Correlation between bidimensional measurements and actual fetal weights was found to be comparable with previously published correlations.
Volume measurements of the fetus may improve the accuracy of estimating fetal size. Additional studies using different volume measurement of the fetus are necessary.
本研究旨在建立一种理想的胎儿三维测量方法，以改进胎儿体重估计。
本研究包括两个阶段。第一阶段是在妊娠28至40周期间进行的前瞻性横断面研究。研究人群（n = 110）包括低风险单胎妊娠，这些孕妇在妊娠晚期接受了常规超声胎儿体重估计。此阶段的目的是确定整个妊娠晚期胎儿腹部和头部体积的正常值。第二阶段是一项前瞻性研究，纳入了在妊娠38至41周期间因择期剖宫产或引产入院的患者（n = 91）。该阶段研究将实际出生体重与胎儿的二维（2D）和三维（3D）测量值进行比较。采用传统二维超声测量胎儿双顶径（BPD）、头围（HC）、腹围（AC）和股骨干长度（FL）。利用虚拟器官计算机辅助分析（VOCAL）计算体积估计值，并计算测量体积与实际新生儿体重之间的相关性。
总体而言，这项纵向研究包括110例妊娠28至41周的患者。计算出了整个妊娠晚期胎儿腹部和头部体积的正常值。91例患者在分娩前三天内进行了超声检查。发现出生体重与腹部体积之间存在良好相关性（r = 0.77），出生体重与头部体积之间存在良好相关性（r = 0.5）。发现二维测量值与实际胎儿体重之间的相关性与先前发表的相关性相当。
胎儿体积测量可能会提高估计胎儿大小的准确性。有必要开展更多使用不同胎儿体积测量方法的研究。
