Loret de Mola J R, Judge N, Entsminger C, DeViney M, Muise K L, Duchon M A
Department of Reproductive Biology, Case Western Reserve University, Cleveland, OH 44106, USA.
J Reprod Med. 1998 Oct;43(10):898-902.
To correlate fetal morphometrics with studies of fetal lung maturity.
One hundred six patients undergoing amniocentesis for fetal lung maturity studies were examined prospectively. Eighty-four patients were normal (79%), and 22 were diabetic (21%). Fetal morphometrics were obtained prior to amniocentesis. The fetal colon and placenta were graded. Discriminant analysis was used to identify variables that were predictive of a mature lecithin/sphingomyelin ratio and the presence of phosphatidylglycerol (PG). All patients delivered within 48 hours of amniocentesis.
In the normal group, 28 (33%) fetuses had a grade 3 colon, which was 68% sensitive and 98% specific for a mature amniocentesis. A grade 3 colon was the single best predictor of a mature amniocentesis (P < .001). Twenty-five (29%) fetuses had a grade 3 placenta, which was 64% sensitive and 96% specific for a mature amniocentesis (P < .005). Diabetes did not influence colonic grading since a grade 3 colon was present in seven (32%) patients (47% sensitivity and 100% specificity for PG) (P < .02). Interexaminer and intraexaminer variability for the study was excellent, kappa = 1.0 (P < .001).
Colonic and placental stage 3 grading are reliable and reproducible ultrasonographic scales that can help predict the findings of fetal lung maturity studies.
将胎儿形态测量学与胎儿肺成熟度研究相关联。
对106例行羊膜腔穿刺术以进行胎儿肺成熟度研究的患者进行前瞻性检查。84例患者正常（79%），22例为糖尿病患者（21%）。在羊膜腔穿刺术前获取胎儿形态测量数据。对胎儿结肠和胎盘进行分级。采用判别分析来识别可预测卵磷脂/鞘磷脂比值成熟及磷脂酰甘油（PG）存在的变量。所有患者在羊膜腔穿刺术后48小时内分娩。
在正常组中，28例（33%）胎儿结肠为3级，对成熟羊膜腔穿刺术的敏感度为68%，特异度为98%。结肠3级是成熟羊膜腔穿刺术的最佳单一预测指标（P <.001）。25例（29%）胎儿胎盘为3级，对成熟羊膜腔穿刺术的敏感度为64%，特异度为96%（P <.005）。糖尿病不影响结肠分级，因为7例（32%）患者存在结肠3级（对PG的敏感度为47%，特异度为100%）（P <.02）。该研究的检查者间和检查者内变异性极佳，kappa = 1.0（P <.001）。
结肠和胎盘3级分级是可靠且可重复的超声检查量表，有助于预测胎儿肺成熟度研究的结果。
