Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA.
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
J Ultrasound Med. 2021 Sep;40(9):1763-1770. doi: 10.1002/jum.15554. Epub 2020 Nov 6.
To assess the average duration of detailed fetal anatomic surveys in pregnancy in relation to gestational age (GA) and the maternal body mass index (BMI) to determine optimal timing of the examination.
This was a retrospective cohort study of gravidae presenting for detailed fetal anatomic examinations between January 1, 2010, and June 30, 2017. After excluding examinations expected to have longer duration (ie, multifetal, major fetal anomalies), there were a total of 6522 examinations performed between GAs of 18 weeks 0 days and 22 weeks 0 days. Women were grouped by BMI, and results were analyzed by logistic regression.
Gravidae of normal weight (BMI, 18.5-24.9 kg/m ) had a decrease of 47.47 seconds of the examination time with each increasing week of gestation (P = .036). Overweight (BMI, 25-29.9 kg/m ) gravidae similarly had a decrease of 66.31 seconds of the examination time with each additional week of gestation (P = .017). Underweight (BMI, 8.5 kg/m ) and obese (BMI, ≥30 kg/m ) gravidae did not have differences in the examination time with increasing GA. Increases in suboptimal examinations were noted with an increasing BMI (P < .001). There was a decreased frequency of suboptimal examinations in obese gravidae with a BMI of 40 kg/m or higher with increasing GA (P = .037).
The duration of detailed fetal anatomic examinations decreased with increasing GA in normal-weight and overweight gravidae but not in obese gravidae. Performing the anatomy scan earlier in class I and II obese gravidae (BMI, 30-40 kg/m ) may enable improved pregnancy management options without increasing the examination duration or likelihood of a suboptimal evaluation.
评估妊娠时详细胎儿解剖检查的平均持续时间与胎龄（GA）和母体体重指数（BMI）的关系，以确定检查的最佳时间。
这是一项回顾性队列研究，纳入了 2010 年 1 月 1 日至 2017 年 6 月 30 日期间进行详细胎儿解剖检查的孕妇。排除预期检查时间较长的检查（即多胎妊娠、严重胎儿畸形）后，共有 6522 例 GA 在 18 周 0 天至 22 周 0 天之间的孕妇纳入研究。根据 BMI 将孕妇分组，采用逻辑回归分析结果。
正常体重（BMI，18.5-24.9kg/m ）孕妇的检查时间随妊娠周数的增加而减少 47.47 秒（P=0.036）。超重（BMI，25-29.9kg/m ）孕妇的检查时间也随妊娠周数的增加而减少 66.31 秒（P=0.017）。而低体重（BMI，<8.5kg/m ）和肥胖（BMI，≥30kg/m ）孕妇的检查时间随 GA 增加无差异。随着 BMI 的增加，亚最佳检查的发生率增加（P<0.001）。随着 GA 的增加，BMI 为 40kg/m 或更高的肥胖孕妇亚最佳检查的频率降低（P=0.037）。
在正常体重和超重孕妇中，详细胎儿解剖检查的持续时间随 GA 的增加而减少，但在肥胖孕妇中则不然。对于 BMI 为 30-40kg/m 的 I 类和 II 类肥胖孕妇，更早地进行解剖检查可能会改善妊娠管理选择，而不会增加检查时间或亚最佳评估的可能性。
