Cartier M S, Doubilet P M
Department of Radiology, Harvard Medical School, Boston, MA 02115.
AJR Am J Roentgenol. 1988 Nov;151(5):991-3. doi: 10.2214/ajr.151.5.991.
The small size of the head and abdomen in a growth-retarded fetus may lead to inaccurate estimates of gestational age. Therefore, we conducted a study to assess the diameters of the aortic root and pulmonary artery in such fetuses. During the study period, we measured these great vessel diameters at the level of the semilunar valves on all third-trimester obstetric sonograms in which intrauterine growth retardation was suspected. Cases were included in the study if delivery occurred within 1 week of the scan and if growth retardation was confirmed after birth. The study population consisted of 75 growth-retarded fetuses. We compared the relationships between great vessel diameters and gestational age in this study population with norms previously established in our laboratory in 403 normal fetuses. In a similar fashion, we compared the relationships between great vessel diameters and biparietal diameter in our study population with previously established norms. We found no significant difference between great vessel diameters in growth-retarded fetuses and those in normal fetuses of the same gestational age (p greater than .45 for aorta; p greater than .40 for pulmonary artery). In contrast, aortic root diameter was larger in relation to biparietal diameter in growth-retarded fetuses than it was in normal fetuses (p less than .05), and there was a tendency toward the same result for the pulmonary artery. We conclude that the diameters of the aorta and pulmonary artery remain normal in most cases of intrauterine growth retardation. The aorta and pulmonary artery may be useful predictors of gestational age when growth retardation is suspected.
生长受限胎儿头部和腹部较小可能导致孕周估计不准确。因此,我们开展了一项研究,以评估此类胎儿主动脉根部和肺动脉的直径。在研究期间,我们在所有怀疑有宫内生长受限的孕晚期产科超声检查中,于半月瓣水平测量这些大血管直径。如果在扫描后1周内分娩且出生后证实存在生长受限,则将病例纳入研究。研究人群包括75例生长受限胎儿。我们将该研究人群中大血管直径与孕周的关系,与我们实验室之前在403例正常胎儿中建立的标准进行比较。同样,我们将研究人群中大血管直径与双顶径的关系,与之前建立的标准进行比较。我们发现,生长受限胎儿的大血管直径与相同孕周正常胎儿的大血管直径之间无显著差异(主动脉p大于0.45;肺动脉p大于0.40)。相比之下,生长受限胎儿的主动脉根部直径相对于双顶径比正常胎儿更大(p小于0.05),肺动脉也有同样的趋势。我们得出结论,在大多数宫内生长受限病例中,主动脉和肺动脉直径保持正常。当怀疑有生长受限时,主动脉和肺动脉可能是孕周的有用预测指标。