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二维超声与临床检查在胎儿体重估计中的诊断价值比较。

Comparison of diagnostic value of two-dimensional ultrasound and clinical examination in fetal weight estimation.

作者信息

Nurzadeh Maryam, Naemi Mahsa, Hasani Shahrzad Sheikh

机构信息

Department of Fetomaternal, Faculty of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Department of Gynecology Oncology, Faculty of Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Family Med Prim Care. 2022 Feb;11(2):775-779. doi: 10.4103/jfmpc.jfmpc_1343_21. Epub 2022 Feb 16.

Abstract

BACKGROUND

Estimation of fetal weight during pregnancy plays an important role in prenatal and intrapartum care and is more important in pregnancies after 37 weeks to determine the type of delivery. The aim of this study was to compare and evaluate the accuracy and diagnostic value of two-dimensional ultrasound and clinical examination in estimating fetal weight and pregnancy outcomes.

MATERIALS AND METHODS

This cross-sectional study was conducted on 300 pregnant women without abnormal fetuses and pregnancies after 37 weeks; mothers who had a normal delivery or cesarean section were evaluated by the available method. The weight of the fetus was estimated before and after delivery, using ultrasound and clinical examination. Newborns were classified into five groups based on their fetal weight. Analysis of collected data was performed with SPSS software.

RESULTS

The mean age of the patients was 31 years and the mean weight of the neonates was 3450 g. At a weight of less than 3000 g, ultrasound and clinical evaluation were strongly correlated with the actual weight of the infant, but at weights of more than 3500 and 4000 g, weight estimation with ultrasound was highly accurate, and clinical examination had poor accuracy. In lower weights, square errors were fewer in both ultrasound and clinical examination, in comparison with higher weights. In higher weights, ultrasound is more reliable, and the diagnostic accuracy of clinical examination is reduced.

CONCLUSION

Estimation of fetal weight with prenatal ultrasound is highly accurate. Clinical examination is more accurate in determining the weight of small fetuses and does not pay much attention to the diagnosis of macrosomic fetuses and even leads to overestimation, while ultrasound is much more accurate in diagnosing fetal macrosomia.

摘要

背景

孕期胎儿体重估计在产前和产时护理中起着重要作用,在孕37周后对于确定分娩方式更为重要。本研究的目的是比较和评估二维超声和临床检查在估计胎儿体重及妊娠结局方面的准确性和诊断价值。

材料与方法

本横断面研究对300例孕37周后无胎儿及妊娠异常的孕妇进行;通过现有方法对顺产或剖宫产的母亲进行评估。在分娩前后使用超声和临床检查估计胎儿体重。根据胎儿体重将新生儿分为五组。使用SPSS软件对收集的数据进行分析。

结果

患者的平均年龄为31岁,新生儿的平均体重为3450克。在体重低于3000克时,超声和临床评估与婴儿实际体重密切相关,但在体重超过3500克和4000克时,超声估计体重的准确性很高,而临床检查的准确性较差。与较高体重相比,在较低体重时,超声和临床检查的平方误差均较少。在较高体重时,超声更可靠,临床检查的诊断准确性降低。

结论

产前超声估计胎儿体重的准确性很高。临床检查在确定小胎儿体重方面更准确,但对巨大胎儿的诊断关注不足,甚至会导致高估,而超声在诊断胎儿巨大儿方面要准确得多。

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