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孕早期二维和三维超声对妊娠结局的影响

Implications of the First Trimester 2d and 3d Ultrasound in Pregnancy Outcome.

作者信息

Tudorache Ş, Căpitănescu R G, Drăgușin R C, Zorilă G L, Marinaș M C, Cernea N, Pătru C L

机构信息

Emergency County Hospital of Craiova, Romania.

Obstetrics and Gynecology Department, University of Medicine and Pharmacy of Craiova, Romania.

出版信息

Curr Health Sci J. 2019 Jul-Sep;45(3):311-315. doi: 10.12865/CHSJ.45.03.10. Epub 2019 Sep 30.

Abstract

BACKGROUND

In this study we researched for the first trimester pregnancy measurements by transabdominal and transvaginal ultrasound: gestational sac volume (GSV), embryo volume (EV), placenta volume (PV), yolk sac volume (YSV) and crown rump lengh (CRL) in predicting pregnancy outcome. Our goals was to demonstrate the ability of the first trimester ultrasound in identifying patients at high risk for abortion, intrauterine growth restriction (IUGR) and low birth weight.

METHODS

Prospective observational clinical study that investigated the role of the first trimester 2D and volumetric (3D) measurements in predicting pregnancy outcome. The study was carried out in the Obstetrics and Gynecology Department of the Emergency County Hospital in Craiova during a study period of 3 years (between 2016 and 2018). The study included a number of 87 pregnancies. Patients included in the study were offered an early 2D and 3D transabdominal and transvaginal ultrasound and afterwards they were followed up until delivery. The statistical analyses (standard deviation, coefficient of variety, Cohen K correlation coefficient) determined a correlation between the two ultrasound methods, between the values of these parameters and pregnancy prognosis, the correlation being more relevant for the 3D ultrasound. The GSV, EV, YSV, PV, CRL and pregnancy outcome was established.

RESULTS

Our study showed that the concordance degree between the two methods was 89.7%. 3D ultrasound had a diagnostic impact in 96.6% of the cases, while 2D ultrasound had a diagnostic impact in 89.6% of the cases. The incidence of the patients at high risk for complications was recorded in pregnancies with abnormal early ultrasound markers.

CONCLUSIONS

First trimester ultrasound is a capable method for identifying a higher percentage of patients at risk of pregnancy complications, counseling and monitoring compared to 2D ultrasound. Also, because there is no radiation exposure, the risks are non-existent.

摘要

背景

在本研究中,我们通过经腹和经阴道超声研究了孕早期的测量指标:妊娠囊体积(GSV)、胚胎体积(EV)、胎盘体积(PV)、卵黄囊体积(YSV)和头臀长(CRL),以预测妊娠结局。我们的目标是证明孕早期超声在识别流产、宫内生长受限(IUGR)和低出生体重高危患者方面的能力。

方法

一项前瞻性观察性临床研究,调查了孕早期二维和容积(三维)测量在预测妊娠结局中的作用。该研究在克拉约瓦县急诊医院妇产科进行,为期3年(2016年至2018年)。该研究纳入了87例妊娠。研究中的患者接受了早期二维和三维经腹及经阴道超声检查,之后对其进行随访直至分娩。统计分析(标准差、变异系数、科恩K相关系数)确定了两种超声方法之间、这些参数值与妊娠预后之间的相关性,三维超声的相关性更强。确定了GSV、EV、YSV、PV、CRL和妊娠结局。

结果

我们的研究表明,两种方法之间的一致性程度为89.7%。三维超声在96.6%的病例中有诊断意义,而二维超声在89.6%的病例中有诊断意义。早期超声标志物异常的妊娠中记录了并发症高危患者的发生率。

结论

与二维超声相比,孕早期超声是一种能够识别更高比例妊娠并发症高危患者、进行咨询和监测的有效方法。此外,由于不存在辐射暴露,风险不存在。

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