Divon M Y, Chamberlain P F, Sipos L, Manning F A, Platt L D
Am J Obstet Gynecol. 1986 Dec;155(6):1197-201. doi: 10.1016/0002-9378(86)90144-4.
This study reviews the roles of sonographic assessment of the rate of growth of the fetal abdominal circumference, the femur length/abdominal circumference ratio, and qualitative determination of amniotic fluid volume as gestational age-independent indices for identification of the small for gestational age fetus. The sensitivity and specificity for single and combinations of test results were evaluated in 50 appropriate for gestational age and 40 small for gestational age fetuses. Positive and negative predictive values were derived for the general population. Our results indicate that either a rate of growth of the fetal abdominal circumference less than or equal to 10 mm/14 days or a femur length/abdominal circumference ratio greater than or equal to 23.5 correctly identifies most small for gestational age fetuses. When the general population is screened, only 15% of small for gestational age fetuses will be missed by this combination of criteria. The presence of a pocket of amniotic fluid less than or equal to 2.0 cm is highly suggestive of a small for gestational age fetus. However, the presence of a pocket of amniotic fluid greater than 2.0 cm does not guarantee an appropriate for gestational age fetus. We conclude that these gestational age-independent indices of fetal growth offer useful tools for differentiating between the small for gestational age and appropriate for gestational age fetus.
本研究回顾了超声评估胎儿腹围生长速率、股骨长度/腹围比值以及羊水容量定性测定作为不依赖孕周的指标用于识别小于孕周胎儿的作用。对50例适于孕周胎儿和40例小于孕周胎儿评估了单项及联合检测结果的敏感性和特异性。得出了一般人群的阳性和阴性预测值。我们的结果表明，胎儿腹围生长速率小于或等于10 mm/14天或股骨长度/腹围比值大于或等于23.5可正确识别大多数小于孕周胎儿。对一般人群进行筛查时，采用这一联合标准仅会漏诊15%的小于孕周胎儿。羊水池小于或等于2.0 cm高度提示小于孕周胎儿。然而，羊水池大于2.0 cm并不能保证胎儿适于孕周。我们得出结论，这些不依赖孕周的胎儿生长指标为区分小于孕周胎儿和适于孕周胎儿提供了有用的工具。
