母亲肥胖对胎儿畸形筛查完成情况的影响。

The impact of maternal obesity on completion of fetal anomaly screening.

作者信息

Eastwood Kelly-Ann, Daly Ciara, Hunter Alyson, McCance David, Young Ian, Holmes Valerie

机构信息

出版信息

J Perinat Med. 2017 Dec 20;45(9):1061-1067. doi: 10.1515/jpm-2016-0048.

DOI:10.1515/jpm-2016-0048

PMID:28145880

Abstract

OBJECTIVE

To examine the impact of maternal obesity on completion of fetal anomaly screening.

METHODS

A retrospective analysis of 500 anomaly scans (19+0-21+6 weeks) was included. Women were categorised according to the World Health Organisation (WHO) body mass index (BMI) classification: normal weight (18.50-24.99 kg/m2), overweight (25.00-29.99 kg/m2), obese class I (30-34.99 kg/m2), obese class II (35.00-39.99 kg/m2) and obese class III (≥40.00 kg/m2). A fetal anomaly imaging scoring system was developed from the National Health Service (NHS) Fetal Anomaly Screening Programme standard to evaluate scans.

RESULTS

Image quality deteriorated as BMI increased and was significantly different across the BMI categories (P<0.001). Performance was poorest in imaging of the fetal chest and was significantly different across BMI categories (P<0.001). In obese class III, 33% of four-chamber cardiac views and 38% of outflow tract views were not obtained. In total, 119 women (23.6%) had an incomplete scan. In obese class III, 44.1% of scans were incomplete compared with 10.2% in the normal BMI category (P<0.001). Of 117 women attending for repeat scans, 78.6% were complete, 11.1% were incomplete, 6.8% were advised to re-attend and 3.4% were referred to Fetal Medicine.

CONCLUSION

Maternal obesity has a significant impact on completion of fetal anomaly screening.

摘要

目的

探讨孕妇肥胖对胎儿畸形筛查完成情况的影响。

方法

纳入对500例异常扫描（孕19+0至21+6周）的回顾性分析。根据世界卫生组织（WHO）的体重指数（BMI）分类对女性进行分组：正常体重（18.50-24.99kg/m²）、超重（25.00-29.99kg/m²）、I级肥胖（30-34.99kg/m²）、II级肥胖（35.00-39.99kg/m²）和III级肥胖（≥40.00kg/m²）。根据国民健康服务体系（NHS）胎儿畸形筛查计划标准开发了胎儿畸形影像评分系统来评估扫描情况。

结果

随着BMI增加，图像质量下降，且在不同BMI类别间存在显著差异（P<0.001）。胎儿胸部成像的表现最差，且在不同BMI类别间存在显著差异（P<0.001）。在III级肥胖孕妇中，33%的四腔心切面和38%的流出道切面未获得。共有119名女性（23.6%）的扫描不完整。在III级肥胖孕妇中，44.1%的扫描不完整，而正常BMI类别中这一比例为10.2%（P<0.001）。在117名接受重复扫描的女性中，78.6%的扫描完整，11.1%的扫描不完整，6.8%的孕妇被建议再次就诊，3.4%的孕妇被转诊至胎儿医学科。