Stratton J F, Scanaill S N, Stuart B, Turner M J
Coombe Women's Hospital, Dublin, Ireland.
Ultrasound Obstet Gynecol. 1995 Feb;5(2):114-8. doi: 10.1046/j.1469-0705.1995.05020114.x.
The objectives of this study were to identify, by means of two third-trimester scans, fetuses with ultrasound evidence of inadequate growth but who were born with birth weights above the 10th centile for gestational age; and to determine if these infants constitute a high-risk group by comparing the incidence of obstetric intervention, of intrapartum complications and of neonatal morbidity between this group and the group of infants who showed no ultrasound evidence of intrauterine growth restraint. A total of 285 women with singleton pregnancies who were referred for a third-trimester ultrasound examination were included in this prospective study. Fetal weight was estimated by ultrasound twice in the third trimester and at each examination was assigned a centile score. A fall of > 20 centiles was taken as evidence of inadequate growth. The outcomes measured were the incidence of abnormal umbilical artery Doppler, induction of labor, meconiumstaining of the liquor, intrapartum fetal blood sampling, operative vaginal delivery, Cesarean section, Apgar score of < 7 at 5 min and admission to the neonatal intensive care unit. Seventy-five patients showed a drop of > 20 centiles between the first and second scans. The incidence of admission to the neonatal intensive care unit was greater in those infants who had ultrasound evidence of growth restraint. We conclude that infants of normal birth weight with inadequate growth diagnosed on ultrasound are not at increased risk, they have an increased incidence of admission to the neonatal intensive care unit, and they are more commonly found in mothers with diabetes mellitus.
本研究的目的是通过两次孕晚期超声检查，识别出那些超声显示生长不足但出生体重高于孕龄第10百分位数的胎儿；并通过比较该组与无超声证据显示宫内生长受限的婴儿组之间的产科干预、产时并发症及新生儿发病率，来确定这些婴儿是否构成高危人群。本前瞻性研究纳入了285名单胎妊娠且被转诊接受孕晚期超声检查的女性。在孕晚期通过超声对胎儿体重进行了两次估计，每次检查都给出一个百分位数评分。下降超过20个百分位数被视为生长不足的证据。所测量的结局包括脐动脉多普勒异常、引产、羊水胎粪污染、产时胎儿血样采集、阴道助产、剖宫产、5分钟时阿氏评分<7以及入住新生儿重症监护病房的发生率。75名患者在第一次和第二次扫描之间下降超过20个百分位数。有超声生长受限证据的婴儿入住新生儿重症监护病房的发生率更高。我们得出结论，超声诊断为生长不足但出生体重正常的婴儿并非风险增加，他们入住新生儿重症监护病房的发生率增加，且更常见于患有糖尿病的母亲。
