Newnham J P, Evans S F, Michael C A, Stanley F J, Landau L I
University Department of Obstetrics and Gynaecology, King Edward Memorial Hospital, Sublaco, Perth, Western Australia.
Lancet. 1993 Oct 9;342(8876):887-91. doi: 10.1016/0140-6736(93)91944-h.
Despite widespread application of ultrasound imaging and Doppler blood flow studies, the effects of their frequent and repeated use in pregnancy have not been evaluated in controlled trials. From 2834 women with single pregnancies at 16-20 weeks gestation, 1415 were selected at random to receive ultrasound imaging and continuous-wave Doppler flow studies at 18, 24, 28, 34, and 38 weeks gestation (the intensive group) and 1419 to receive single ultrasound imaging at 18 weeks (the regular group). Outcome data was obtained from 99% of women who entered the study. The only difference between the two groups was significantly higher intrauterine growth restriction in the intensive group, when expressed both as birthweight < 10th centile (relative risk 1.35; 95% confidence interval 1.09 to 1.67; p = 0.006) and birthweight < 3rd centile (relative risk 1.65; 95% confidence intervals 1.09 to 2.49; p = 0.020). While it is possible that this finding was a chance effect, it is also plausible that frequent exposure to ultrasound may have influenced fetal growth. Repeated prenatal ultrasound imaging and Doppler flow examinations should be restricted to those women to whom the information is likely to be of clinical benefit.
尽管超声成像和多普勒血流研究已得到广泛应用,但它们在孕期频繁和重复使用的影响尚未在对照试验中得到评估。在2834名单胎妊娠且孕周为16 - 20周的女性中,随机选择1415名在妊娠18、24、28、34和38周接受超声成像和连续波多普勒血流研究(强化组),1419名在18周接受单次超声成像(常规组)。99%进入研究的女性获得了结局数据。两组之间唯一的差异是强化组的宫内生长受限显著更高,这一差异在出生体重低于第10百分位数(相对风险1.35;95%置信区间1.09至1.67;p = 0.006)和出生体重低于第3百分位数(相对风险1.65;95%置信区间1.09至2.49;p = 0.020)时均有体现。虽然这一发现有可能是偶然效应,但频繁接触超声可能影响胎儿生长这一说法也看似合理。重复的产前超声成像和多普勒血流检查应仅限于那些可能从该信息中获得临床益处的女性。