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宫内胎儿生长受限的超声与生化检测及产前治疗(作者译)

[Ultrasonic and biochemical detection and prenatal treatments of intra-uterine fetal growth retardation (author's transl)].

作者信息

Kaneoka T, Aso M, Nobori M, Aonuma M, Shimizu H, Shirakawa K

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1980 Jan;32(1):103-12.

PMID:6165785
Abstract

Efficacy of three ultrasonographic and six biochemical methods for the detection of intrauterine growth retardation were assessed in prospective studies of 40 cases associated with short uterine fundal height less than -1.5 SD and/or small ultrasonographically determined total intrauterine volume (TIUV) less than -1 SD of normal populations. Prenatal treatments, consisting of bed rest, high protein diet, intravenous drip infusion of 10% maltose, 500 ml per day, for more than 12 days, etc., were administered on them. Fifteen cases (37.5%) delivered small-for-date infants, 9 of which complicated by toxemia of pregnancy. At the final determinations, small TIUV were found in all small-for-date cases (100%), short biparietal diameter 80.0%, and short longitudinal intracavital uterine length 53.3% of 15 small-for-date cases. In biochemical parameters, low maternal plasma estriol levels were found in 73.3%, low plasma human placental lactogen levels 66.7%, low urinary estriol excretion 53.3%, abnormal plasma alpha-fetoprotein levels 33.3%, and low plasma progesterone levels 20.0% of 15 small-for-date cases. Nineteen cases (47.5%) demonstrated remarkable increases in TIUV following prenatal treatments, and delivered appropriate-for-date infants. Despite of marked growth in biophysical parameters, abnormal biochemical values were mostly not improved by these treatments.

摘要

在一项前瞻性研究中,对40例子宫底高度短于-1.5标准差和/或超声测定的子宫内总体积(TIUV)小于正常人群-1标准差的病例,评估了三种超声检查方法和六种生化方法检测宫内生长迟缓的有效性。对这些病例进行了包括卧床休息、高蛋白饮食、每天静脉滴注10%麦芽糖500毫升、持续12天以上等产前治疗。15例(37.5%)分娩了小于孕周的婴儿,其中9例并发妊娠中毒症。在最终测定中,15例小于孕周的病例中,所有病例(100%)的TIUV小,双顶径短的占80.0%,宫腔内子宫纵径短的占53.3%。在生化参数方面,15例小于孕周的病例中,73.3%的孕妇血浆雌三醇水平低,66.7%的血浆人胎盘催乳素水平低,53.3%的尿雌三醇排泄量低,33.3%的血浆甲胎蛋白水平异常,20.0%的血浆孕酮水平低。19例(47.5%)在产前治疗后TIUV显著增加,并分娩了适于孕周的婴儿。尽管生物物理参数有明显增长,但这些治疗大多未能改善异常的生化值。

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