Gross T L, Sokol R J, Kazzi G M, Wolfson R N, Kazzi N J
Am J Obstet Gynecol. 1984 Jun 1;149(3):311-9. doi: 10.1016/0002-9378(84)90231-x.
For several years standard obstetric practice has been to perform an amniocentesis for evaluation of fetal maturity. In order to provide a more definitive answer as to which pregnancies need an amniocentesis, a group of 294 nondiabetic pregnant women in whom an amniocentesis for the evaluation of fetal maturity had been performed for clinical indications were evaluated. Three predictors of fetal maturity--obstetric estimate of gestational age, fetal biparietal diameter, and ultrasonic determination of placental maturation--were evaluated for their ability to predict three outcomes of fetal maturity, including positive amniotic fluid phosphatidylglycerol, pediatric estimate of gestational age greater than or equal to 38 weeks, and absence of hyaline membrane disease. A fetal biparietal diameter of greater than or equal to 90 mm was present in 36% of the total population and was associated with 97% term delivery, 87% positive amniotic fluid phosphatidylglycerol, and 0% hyaline membrane disease. The results associated with an obstetric estimate of gestational age of greater than or equal to 38 weeks were similar. In the present data set over one third of clinically indicated amniocenteses could potentially be avoided without losing any predictive capability for fetal maturity.
数年来，标准的产科操作是进行羊膜穿刺术以评估胎儿成熟度。为了更确切地回答哪些孕妇需要进行羊膜穿刺术，对一组294名非糖尿病孕妇进行了评估，这些孕妇因临床指征进行了羊膜穿刺术以评估胎儿成熟度。评估了胎儿成熟度的三个预测指标——产科估计孕周、胎儿双顶径以及胎盘成熟度的超声测定——预测胎儿成熟度的三个结果的能力，这三个结果包括羊水磷脂酰甘油阳性、儿科估计孕周大于或等于38周以及无透明膜病。在总人口中，36%的胎儿双顶径大于或等于90毫米，这与97%的足月分娩、87%的羊水磷脂酰甘油阳性以及0%的透明膜病相关。与产科估计孕周大于或等于38周相关的结果相似。在当前数据集中，超过三分之一的临床指征性羊膜穿刺术可能可以避免，而不会丧失任何预测胎儿成熟度的能力。
