David C, Tagliavini G, Pilu G, Rudenholz A, Bovicelli L
Department of Obstetrics and Gynecology, Bologna University School of Medicine, Italy.
Am J Obstet Gynecol. 1996 Mar;174(3):1037-42. doi: 10.1016/s0002-9378(96)70347-2.
Our purpose was to assess the accuracy of third-trimester ultrasonographic biometry in the diagnosis of small-for-gestational-age fetuses in a low-risk obstetric population.
A total of 1000 low-risk pregnancies were prospectively examined at 31 weeks' gestation. The diagnostic accuracy of the fetal abdominal circumference and estimated fetal weight according to 24 formulas in the literature were evaluated by the use of receiver-operator characteristic curves.
The incidence of a birth weight <10th percentile was 8.2%. The diagnostic accuracies of abdominal circumference and estimated fetal weight were remarkably similar. None of the 24 formulas performed significantly better than the measurement of the abdominal circumference. At a specificity of 90%, 46% of infants with a birth weight <10th percentile and five of six cases with adverse perinatal outcomes were predicted.
In a low-risk obstetric population third-trimester ultrasonographic biometry has limited value in predicting small-for-gestational-age fetuses, and estimation of fetal weight does not carry an advantage over measurement of the abdominal circumference. The optimal cutoff value remains uncertain. However, by accepting a 10% false-positive rate, half of small-for-gestational-age fetuses and most perinatal complications could be recognized.
我们的目的是评估孕晚期超声生物测量法在诊断低风险产科人群中小于胎龄儿方面的准确性。
对总共1000例低风险妊娠在孕31周时进行前瞻性检查。通过使用受试者工作特征曲线评估根据文献中的24种公式得出的胎儿腹围和估计胎儿体重的诊断准确性。
出生体重低于第10百分位数的发生率为8.2%。腹围和估计胎儿体重的诊断准确性非常相似。24种公式中没有一种比腹围测量表现得明显更好。在特异性为90%时，预测出了46%出生体重低于第10百分位数的婴儿以及六例围产期不良结局病例中的五例。
在低风险产科人群中，孕晚期超声生物测量法在预测小于胎龄儿方面价值有限，并且估计胎儿体重并不比测量腹围更具优势。最佳临界值仍不确定。然而，若接受10%的假阳性率，则可以识别出一半的小于胎龄儿和大多数围产期并发症。
