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腹部周长与估计胎儿体重对晚期胎儿生长受限的检测的纵向评估。

Longitudinal Assessment of Abdominal Circumference versus Estimated Fetal Weight in the Detection of Late Fetal Growth Restriction.

机构信息

Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, Barcelona, Spain.

Fetal Medicine Unit, Clínica Dávila, Santiago, Chile.

出版信息

Fetal Diagn Ther. 2019;45(4):230-237. doi: 10.1159/000485889. Epub 2018 Jan 16.

Abstract

OBJECTIVES

To perform a longitudinal assessment comparison between estimated fetal weight (EFW) and abdominal circumference (AC) in the prediction of late fetal growth restriction (FGR) as opposed to small for gestational age (SGA).

PATIENTS AND METHODS

A cohort of unselected singleton pregnancies scanned at 32±2 and 37±1 weeks was created. Longitudinal growth assessment by calculating the conditional AC and conditional EFW was performed, and both parameters were compared for their prediction capacity for late FGR and SGA. Conditional standards set an expected size (EFW or AC) given a first measurement performed earlier. A declining growth was defined as a conditional growth of <10th centile.

RESULTS

A total of 938 pregnancies were included. As expected, declining growth between 32±2 and 37±1 weeks was associated with late FGR and SGA, but the predictive capacity of both conditional AC and conditional EFW was comparably poor, with detection rates of 28% at a 10% rate of false positives for late FGR.

CONCLUSIONS

Longitudinal assessment of fetal growth during the third trimester has a low predictive capacity for late FGR, with no differences between conditional AC and conditional EFW.

摘要

目的

对估计胎儿体重(EFW)和腹围(AC)在预测晚期胎儿生长受限(FGR)与小于胎龄儿(SGA)方面的纵向评估进行比较。

患者和方法

创建了一个在 32±2 周和 37±1 周进行扫描的未选择的单胎妊娠队列。通过计算条件 AC 和条件 EFW 进行了纵向生长评估,并比较了这两个参数对晚期 FGR 和 SGA 的预测能力。条件标准根据较早进行的第一次测量设定了预期大小(EFW 或 AC)。下降的生长定义为条件生长<第 10 百分位。

结果

共纳入 938 例妊娠。如预期的那样,32±2 至 37±1 周之间的下降生长与晚期 FGR 和 SGA 相关,但条件 AC 和条件 EFW 的预测能力均较差,晚期 FGR 的假阳性率为 10%时,检测率为 28%。

结论

在妊娠晚期进行胎儿生长的纵向评估对晚期 FGR 的预测能力较低,条件 AC 和条件 EFW 之间没有差异。

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