Santolaya-Forgas J, Meyer W J, Gauthier D W, Kahn D
Department of Obstetrics and Gynecology, University of Illinois at Chicago 60612-7313.
Am J Obstet Gynecol. 1994 Oct;171(4):1072-5. doi: 10.1016/0002-9378(94)90038-8.
Our purpose was to compare the accuracy of ultrasonographic intrapartum measurement of fetal abdominal circumference, estimated fetal weight, and fetal subcutaneous tissue/femur length ratio in predicting large-for-gestational-age fetuses.
A cross-sectional analysis of 173 normal patients delivered of normal, appropriate-for-gestational-age infants (group 1) was performed to determine the normal changes of standard fetal biometric parameters and subcutaneous tissue throughout pregnancy. Measurements of fetal subcutaneous tissue were made at the level of the femoral diaphysis. A second group of 101 well-dated patients had these measurements obtained within 24 hours of delivery (group 2). Large for gestational age was defined as a birth weight > 90th percentile for gestational age. The sensitivity and specificity for prediction of large for gestational age of an intrapartum measurement of an abdominal circumference > 90th percentile, estimated fetal weight > 90th percentile, and fetal subcutaneous tissue/femur length ratio > 2 deviations of the mean was calculated.
In group 1 the mean gestational age was 31.4 +/- 5.4 weeks (range 17 to 41 weeks). The femur length, abdominal circumference, and fetal subcutaneous tissue correlated well with gestational age (p < 0.0001). The fetal subcutaneous tissue/femur length ratio was stable throughout pregnancy, with a mean of 0.05 +/- 0.014 (range 0.02 to 0.09, R2 0.09). In group 2 mean gestational age was 38 +/- 2.5 weeks (range 30 to 42 weeks). Mean birth weight was 3280 +/- 740 gm (range 1513 to 4801 gm). Nineteen (19%) fetuses were large for gestational age. Significant differences were found between the appropriate- and large-for-gestational-age fetuses for birth weight, abdominal circumference, estimated fetal weight, and fetal subcutaneous tissue/femur length ratio (p < 0.0001). The sensitivity and specificity of the fetal abdominal circumference, estimated fetal weight, and fetal subcutaneous tissue/femur length ratio were 44% and 98%, 68% and 85%, and 82% and 96%, respectively.
The fetal subcutaneous tissue/femur length ratio is a gestational age-independent parameter that has a greater sensitivity than the fetal abdominal circumference or estimated fetal weight formula for the intrapartum identification of large-for-gestational-age fetuses.
我们的目的是比较超声在产时测量胎儿腹围、估计胎儿体重以及胎儿皮下组织/股骨长度比值以预测大于胎龄儿方面的准确性。
对173例分娩出正常、适于胎龄儿的正常患者（第1组）进行横断面分析，以确定整个孕期标准胎儿生物测量参数和皮下组织的正常变化。在股骨干水平测量胎儿皮下组织。第二组101例孕周明确的患者在分娩后24小时内进行这些测量（第2组）。大于胎龄定义为出生体重>胎龄的第90百分位数。计算产时测量腹围>第90百分位数、估计胎儿体重>第90百分位数以及胎儿皮下组织/股骨长度比值>均值2个标准差时预测大于胎龄的敏感性和特异性。
第1组平均孕周为31.4±5.4周（范围17至41周）。股骨长度、腹围和胎儿皮下组织与孕周相关性良好（p<0.0001）。胎儿皮下组织/股骨长度比值在整个孕期保持稳定，均值为0.05±0.014（范围0.02至0.09，R2 0.09）。第2组平均孕周为38±2.5周（范围30至42周）。平均出生体重为3280±
