通过胎儿脐静脉血流和母体血液动力学来区分 SGA 和 FGR。

Distinction between SGA and FGR by means of fetal umbilical vein flow and maternal hemodynamics.

机构信息

Department of Surgery, University of Rome Tor Vergata, Rome, Italy.

Department of Obstetrics and Gynecology, Policlinico Casilino Hospital, Rome, Italy.

出版信息

J Matern Fetal Neonatal Med. 2022 Dec;35(25):6593-6599. doi: 10.1080/14767058.2021.1918091. Epub 2021 May 2.

DOI:10.1080/14767058.2021.1918091

PMID:33938366

Abstract

OBJECTIVES

To improve identification of fetal growth restriction (FGR) by means of umbilical venous flow (QUV) and maternal hemodynamics, including systemic vascular resistance (SVR) and cardiac output (CO), in order to distinguish between FGR and SGA.

METHODS

We enrolled 68 pregnancies (36 SGA, 8 early FGR and 24 late FGR) who underwent a complete fetal hemodynamic examination including QUV and a noninvasive maternal hemodynamics assessment by means of USCOM.

RESULTS

In comparison with SGA, QUV and corrected for estimated fetal weight QUV (cQUV) were significantly lower in early and late-FGR. In addition, maternal CO was lower in early and late-FGR, while SVR was lower only in early-onset FGR. According to ROC analysis, cQUV centile (AUC 0.92, 0.72) was the best parameter for the prediction of SGA before and after 32 weeks, followed by SVR and CO. For all parameters, the prediction was always better in the case of early-onset FGR <32 weeks.

CONCLUSIONS

UV flow and maternal hemodynamics examination are useful tools to accurately discern between SGA and FGR.

摘要

目的

通过脐静脉血流（QUV）和母体血液动力学（包括全身血管阻力[SVR]和心输出量[CO]）来提高胎儿生长受限（FGR）的识别能力，以便区分 FGR 和 SGA。

方法

我们纳入了 68 例妊娠（36 例 SGA、8 例早期 FGR 和 24 例晚期 FGR），这些患者接受了完整的胎儿血液动力学检查，包括 QUV 和 USCOM 进行的无创性母体血液动力学评估。

结果

与 SGA 相比，早期和晚期 FGR 的 QUV 和校正估计胎儿体重的 QUV（cQUV）显著降低。此外，早期和晚期 FGR 的母体 CO 降低，而 SVR 仅在早期 FGR 中降低。根据 ROC 分析，cQUV 百分位数（AUC 0.92、0.72）是预测 32 周前和 32 周后 SGA 的最佳参数，其次是 SVR 和 CO。对于所有参数，早期 FGR <32 周的预测效果始终更好。