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横小脑直径在孕中期和孕晚期估计孕周中的准确性:沙特阿拉伯的一项前瞻性研究

Accuracy of Transverse Cerebellar Diameter in Estimating Gestational Age in the Second and Third Trimester: A Prospective Study in Saudi Arabia.

作者信息

Gareeballah Awadia, Alshoabi Sultan Abdulwadoud, Alharbi Ashwaq Mohammed, Alali Mashael Hisham, Alraddadi Wed Mubarak, Al-Ahmadi Fadwa Mohammed, Dwaidy Reem Mustafa, Alamri Rahaf, Alkhoudair Wessal Abdulkarim, Alsharif Walaa, Elzaki Maisa, Alsaedi Amirah Faisal, Gameraddin Moawia, Abdulaal Osama Mohammed, Adam Mohammed

机构信息

Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia.

King Salman Medical City-Maternity and Children's Hospital, Al-Madina Al-Munawwarah 42319, Saudi Arabia.

出版信息

Diagnostics (Basel). 2025 Apr 29;15(9):1130. doi: 10.3390/diagnostics15091130.

Abstract

Failure to accurately estimate gestational age remains an important dilemma for optimal evidence-based antenatal care. Currently, when the last menstrual period (LMP) is unknown, ultrasonography measurement is the best method for estimating gestational age (GA). This study aims to assess the feasibility and accuracy of ultrasonography measurement of the transverse cerebellar diameter (TCD) to deduce fetal GA after 13 weeks of gestation. A prospective study was conducted on 384 normal singleton pregnancies. Demographic information and biometric measurements, including TCD, were collected using a data sheet. The data were then analyzed using SPSS version 27, DATAtab, and the R program. The study found a strong significant association between GA based on TCD and the LMP, GA based on femur length (FL), GA based on biparietal diameter (BPD), GA based on abdominal circumference (AC), and GA based on the average gestational age (AVG) (r = 0.976, 0.970, 0.966, 0.968, and 0.984, respectively, < 0.001). Furthermore, there was perfect agreement between GA estimated using TCD and GA based on LMP, with a mean difference of 0.41 weeks and upper and lower limits of agreement of -1.43 to 2.26 weeks. Ultrasonography measurements of the TCD accurately predict gestational age with excellent concordance with GA based on the LMP, FL, AC, and BPD. TCD can be used as a reliable estimator of GA in the second and third trimesters of pregnancy with the benefit of its brain-sparing effect in fetuses of fetal intrauterine growth restriction pregnancies. Combining TCD with FL, BPD, and AC provides the most accurate method of GA prediction.

摘要

未能准确估计孕周仍然是优化循证产前护理的一个重要难题。目前,当末次月经日期(LMP)未知时,超声测量是估计孕周(GA)的最佳方法。本研究旨在评估妊娠13周后通过超声测量小脑横径(TCD)来推断胎儿孕周的可行性和准确性。对384例正常单胎妊娠进行了一项前瞻性研究。使用数据表收集人口统计学信息和生物测量数据,包括TCD。然后使用SPSS 27版、DATAtab和R程序对数据进行分析。研究发现,基于TCD的孕周与基于LMP的孕周、基于股骨长度(FL)的孕周、基于双顶径(BPD)的孕周、基于腹围(AC)的孕周以及基于平均孕周(AVG)的孕周之间存在很强的显著相关性(r分别为0.976、0.970、0.966、0.968和0.984,<0.001)。此外,使用TCD估计的孕周与基于LMP的孕周之间完全一致,平均差异为0.41周,一致性的上限和下限为-1.43至2.26周。超声测量TCD能准确预测孕周,与基于LMP、FL、AC和BPD的孕周具有极好的一致性。TCD可作为妊娠中晚期孕周的可靠估计指标,其优势在于对胎儿宫内生长受限妊娠的胎儿具有脑保护作用。将TCD与FL、BPD和AC相结合可提供最准确的孕周预测方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d83e/12072083/18b319c3efe6/diagnostics-15-01130-g001.jpg

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