University Department of Obstetrics and Gynecology at The Hospital St. Hedwig of The Order of St. John, University of Regensburg, Steinmetzstr. 1-3, 93049, Regensburg, Germany.
Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital of Essen, Hufelandstraße 55, 45147, Essen, Germany.
Arch Gynecol Obstet. 2023 Oct;308(4):1151-1158. doi: 10.1007/s00404-022-06762-3. Epub 2022 Sep 10.
To determine whether the presence of anhydramnios significantly influences the sonographic estimated fetal weight (EFW) compared to a matched cohort with normal amniotic fluid volume.
The study sample of this retrospective case-control study consisted of 114 pregnant women who presented to a Tertiary Perinatal Clinic between 2015 and 2020. 57 of them presented with an anhydramnios and a matched cohort of 57 women with normal amniotic fluid volume. At time of admission, gestational age varied between 22 + 4 and 42 + 6 weeks of pregnancy. All women underwent detailed ultrasound assessment for EFW and amniotic fluid index. To determine EFW Hadlock's estimation formula I was used which is based on measurements of biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL). The EFW was compared with the weight at delivery. The maximum time interval between measurement and delivery was 5 days.
There was neither a significant difference between the case and control group with regard to gestational age at ultrasound in days (median 249 days and 246 days, p = 0.97), nor to gestational age at birth (median 249 days and 247 days, p = 0.98). Concerning the newborns parameters, the body length at birth was not significantly different between the case and control group in centimeters (cm) (median 47 cm and 47 cm, p = 0.79). EFW in gram (g) was lower than birth weight in both groups and did not differ significantly between case and control group (estimated weight median 2247 g and 2421 g, p = 0.46; birth weight median 2440 g and 2475 g, p = 0.47). The difference between EFW and birth weight in percent (%) did not differ between the case and control group (median - 3.9% and - 5.6%, p = 0.70). The maternal parameters showed that the patients in the case group were younger (median 31 years and 38 years p = 0.20) and had a significantly higher body mass index (BMI) (median 27.3 kg/m vs 22.0 kg/m, < 0.001) compared to the control group.
Our study shows for the first time that EFW in women with anhydramnios can be determined sonographically just as accurately as in a matched cohort with normal amniotic fluid volume. A reliable estimation of fetal weight is crucial for optimal assessment of the newborns prognosis and counseling of the parents especially when advising women in the early weeks of pregnancy at the limit of viability.
与羊水正常的匹配队列相比，确定羊水过少是否显著影响超声估计胎儿体重（EFW）。
本回顾性病例对照研究的研究样本包括 2015 年至 2020 年间在一家三级围产诊所就诊的 114 名孕妇。其中 57 名孕妇羊水过少，57 名孕妇羊水正常。入院时，妊娠龄在 22+4 周至 42+6 周之间。所有女性均接受详细的超声检查以评估 EFW 和羊水指数。EFW 使用 Hadlock 估计公式 I 进行评估，该公式基于双顶骨直径（BPD）、头围（HC）、腹围（AC）和股骨长度（FL）的测量值。EFW 与分娩时的体重进行比较。测量与分娩之间的最大时间间隔为 5 天。
病例组和对照组的超声检查时的孕龄（中位数 249 天和 246 天，p=0.97）以及分娩时的孕龄（中位数 249 天和 247 天，p=0.98）均无显著差异。关于新生儿参数，病例组和对照组出生时的身长（cm）无显著差异（中位数 47cm 和 47cm，p=0.79）。EFW（g）低于两组的出生体重，病例组和对照组之间无显著差异（估计体重中位数 2247g 和 2421g，p=0.46；出生体重中位数 2440g 和 2475g，p=0.47）。EFW 与出生体重的百分比（%）差值在病例组和对照组之间无差异（中位数-3.9%和-5.6%，p=0.70）。母体参数显示，病例组患者年龄较小（中位数 31 岁和 38 岁，p=0.20），体重指数（BMI）显著较高（中位数 27.3kg/m 与 22.0kg/m，<0.001）。
我们的研究首次表明，在羊水过少的女性中，EFW 可以像在羊水正常的匹配队列中一样准确地通过超声确定。对胎儿体重的可靠估计对于最佳评估新生儿的预后和对父母的咨询至关重要，尤其是在妊娠早期接近生存极限时对孕妇进行咨询时。
