超声测量胎儿股骨皮下组织厚度与预测出生体重的相关性探讨

目的为预测新生儿出生体重.方法应用超声对100例正常孕妇在分娩前1周内测量股骨皮下组织厚度(TSTT)、双顶径(BPD)、腹围(AC)、股骨长度(FL),并与新生儿出生体重的关系进行分析.结果股骨皮下组织厚度与体重的相关性最好(R=0.9027),逐步回归分析中FTSTT的F值最大(F=198.67).结论超声测量胎儿股骨皮下组织厚度预测出生体重的方法简单、准确,有较好的临床应用价值.     

单项超声测量指标预测胎儿体重的临床应用

目的：探讨应用胎儿腹围单项超声测量指标预测胎儿出生体重的临床价值。方法：（１）应用Ｂ型超声对３００例胎儿的腹围、小脑横径、双顶径、股骨长进行测量，并与新生儿出生体重的关系进行分析。经单元线性回归得出腹围预测胎儿体重的单元方程式。（２）应用此方程对３３０例胎儿进行前瞻性验证。结果：腹围与新生儿体重的相关性最好，（ｒ＝０．８６６７９）。依据腹围可以初步预测胎儿出生的体重范围。其符合率达８０．０％。结论：应用超声测量胎儿腹围预测出生体重，方法简单，且较准确，有较好的临床实用价值。     

超声测量胎儿腹围预测新生儿出生体重的研究

目的探讨超声测量胎儿腹围在预测新生儿出生体重和诊断巨大儿中的价值。方法在孕妇分娩前1周超声测量胎儿腹围,追踪胎儿的出生体重,分析胎儿腹围与出生体重的关系。结果(1)共检测1475例单胎孕妇胎儿,胎儿腹围与出生体重呈直线正相关关系,r为0.85(P<0.01)。(2)胎儿腹围<34cm者中无一例巨大儿;胎儿腹围<35cm有1007例,99.7%的新生儿平均出生体重<4000g;胎儿腹围在35～35.9cm有206例,新生儿平均出生体重为(3691±277)g,其中14.6%(30例)的新生儿出生体重≥4000g;胎儿腹围在36～36.9cm有149例,其中51.0%(76例)的新生儿出生体重≥4000g,新生儿平均出生体重为(3957±256)g;胎儿腹围在37～37.9cm有64例,其中84.4%(54例)的新生儿出生体重≥4000g,平均出生体重(4205±250)g;胎儿腹围≥38cm有44例,新生儿平均出生体重≥4000g者为100%(44例),平均出生体重为(4489±267)g。(3)1475例中有811例孕妇行剖宫产术(55.0%),新生儿出生体重为4000～4500g者,剖宫产率为71.4%(125/175),出生体重≥4500g者,剖宫产率为93.8%(30/32),均显著高于新生儿出生体重<4000g的剖宫产率(P<0.01)。结论超声测量胎儿腹围可以预测新生儿出生体重。胎儿腹围与胎儿体重呈高度直线正相关。胎儿腹围<35cm提示发生巨大儿的可能性极低;≥37cm提示巨大儿的可能性大。     

超声测量胎儿腹围、小脑横径预测胎儿体重的研究

研究超声测量胎儿腹围 (AC)、小脑横径 (TCD)预测胎儿体重(FW)的可行性。方法 :应用B超测量 30 0例胎儿的AC、TCD、双顶径 (BPD)及股骨长度 (FL) ,并与新生儿出生体重进行相关分析 ,经二元线性回归导出AC、TCD预测FW的方程式。并对 4 0 0例胎儿用此方程式进行临床验证。结果 :AC与出生体重的相关性最好 ,TCD次之 ,其简单相关系数分别为 0 86435(P <0 0 0 1)、0 61718(P<0 0 0 1) ;偏相关系数分别为 0 78955(P <0 0 0 1)、0 162 90 (P <0 0 0 1)。以这二项指标预测FW的方程式为 :FW =190 .6×AC +332 8×TCD - 4 4 91 5,经 4 0 0例临床验证 ,符合率达 86 5% ,相对误差 <10 %者占 92 5%。结论 :超声测量胎儿AC、TCD预测FW ,方法简便 ,且较准确 ,有较好的临床实用价值。     

超声测量胎儿腹围预测巨大胎儿

目的　探讨产前预测新生儿出生体重的相关因素及超声测量胎儿腹围能否预测巨大胎儿。　方法　前瞻性选择 148例宫高 腹围≥ 135 cm的足月单胎已临产的孕妇 ,超声测量其胎儿双顶径、腹围、股骨长度 ,皮尺测量孕妇宫高、腹围 ,核对孕龄 ,分析这些因素与新生儿出生体重的相关性 ;按新生儿体重将这些孕妇分为巨大儿组和非巨大儿组 ,比较两组的资料 ;分析胎儿腹围与巨大儿的特定关系。　结果　多因素逐步回归分析显示单一胎儿腹围是预测胎儿体重的最好参数 ,优于胎儿腹围与股骨长的联合应用。其与胎儿体重呈直线正相关 ,r=0 .85。胎儿腹围≥ 36 cm可以预测 82 %的巨大儿 ,巨大儿组剖宫产率 70 .2 %。　结论　胎儿腹围与胎儿体重呈高度直线正相关 ,是预测胎儿体重的较好参数。在产前怀疑有巨大儿的可能时 ,超声测量胎儿腹围有助于其诊断。     

超声测量胎儿腹部皮下组织厚度预测胎儿体重的临床观察

目的探讨应用超声测量胎儿腹部皮下组织厚度预测胎儿体重的临床价值。方法对2002年5月至2003年12月在朝阳市第二人民医院分娩的256例孕妇,应用超声测量胎儿双顶径（BPD）、头围（HC）、腹围（AC）、股骨长度（FL）、股骨皮下组织厚度（FSTT）及腹部皮下组织厚度（ASTT）,并且与新生儿出生体重进行直线回归分析。结果各项测量指标与出生体重均有一定的相关性（P均〈0.05）,以ASTT估计胎儿体重优于其他各项指标（r=0.868）。结论超声测量胎儿腹部皮下组织厚度预测胎儿体重相对准确,方法简便,有较好的临床应用价值。     

B超测量胎儿腹围预测新生儿体重的临床研究

目的:探讨超声测量胎儿腹围在预测新生儿出生体重和诊断巨大儿中的价值。方法:在孕妇分娩前3天内超声测量胎儿腹围,追踪胎儿的出生体重,分析胎儿腹围与出生体重的关系。结果:①共检测2167例单胎孕妇胎儿,胎儿腹围与出生体重呈直线正相关关系(r=0.97,P=0)。②胎儿腹围<34 cm者有7例巨大儿;胎儿腹围<35 cm有1436例,99%的新生儿出生体重<4000 g;胎儿腹围在35~35.9 cm有335例,新生儿平均出生体重为3525.0±249.7 g,巨大儿发生率为5.7%(19例),胎儿腹围在36~36.9 cm有224例,新生儿平均出生体重为3737.1±264.3 g,巨大儿发生率为21.4%(48例);胎儿腹围在37~37.9 cm有100例,平均出生体重3905.1±255.3g,巨大儿发生率为39%(39例),胎儿腹围≥38 cm有38例,新生儿平均出生体重4115.5±306.1g,巨大儿发生率71.1%(27例)。结论:超声测量胎儿腹围可以预测新生儿出生体重,胎儿腹围与胎儿体重呈高度直线正相关,胎儿腹围<35 cm提示发生巨大儿的可能性低;≥37.7 cm提示发生巨大儿的可能性大。     

B超测量胎儿肝脏面积预测巨大儿的临床价值

目的 :研究应用B型超声测量胎儿肝脏面积预测巨大儿的临床价值。方法 :应用B型超声测量 36 0例足月妊娠胎儿的双顶径、头围、腹围、股骨长度、股骨皮下组织厚度、肝脏长度和肝脏面积 ,并分析各预测指标与新生儿出生体重的关系及用于预测巨大儿的敏感性和特异性。结果 :各项预测指标中胎儿肝脏面积与新生儿体重的相关性最好 (r =0 .80 6 ) ,对巨大儿诊断的敏感性为 88 89% ,特异性为 95 4 2 %。结论 :应用B型超声测量胎儿肝脏面积预测巨大儿的准确性较高 ,具有临床应用价值     

B型超声预测胎儿体重的研究进展

Ｂ型超声预测胎儿体重的研究进展朱洁萍戴钟英为了正确地制定产科处理措施，减少产科并发症，准确地估计胎儿体重是十分重要的工作。过去临床上常用的方法是根据子宫高度、子宫宽度及腹围的测量来估计胎儿体重。７０年代末期以来，随着超声技术的发展，Ｂ型超声检查成为预...     

胎儿长骨超声测量筛查唐氏综合征的价值

目的 探讨胎儿短长骨与唐氏综合征的关系.方法 对5年来经细胞遗传学证实为唐氏综合征胎儿超声测量其股骨长度及肱骨长度与同孕龄正常胎儿股骨长度及肱骨长度进行比较.结果 唐氏综合征胎儿的长骨较同孕龄正常胎儿的长骨短,两者差异有显著性(P＜0.01).当胎儿股骨长度测量值与同孕龄正常胎儿股骨长度平均值的比值(MFL/PFL)及胎儿肱骨长度测量值与同孕龄正常胎儿肱骨长度平均值的比值(MHL/PHL)≤0.9的截断值时对检出唐氏综合征胎儿的敏感性分别为50%及66.7%,特异性分别为91.6%及91.7%,阳性预测值分别为8.7%及11.4%;当胎儿股骨长度及肱骨长度较同孕龄正常胎儿股骨长度及肱骨长度短,且＞1SD时对检出唐氏综合征胎儿的敏感性分别为75.0%及83.0%,特异性分别为76.5%及76.8%,阳性预测值分别为5.8%及6.5%.结论 产前B超测量胎儿股骨长度及肱骨长度对筛查唐氏综合征患儿有很重要的临床价值.     

Comparison of the accuracy of INTERGROWTH-21 formula with other ultrasound formulae in fetal weight estimation

Objective

A new ultrasound formula for fetal weight estimation was proposed from the INTERGROWTH-21 project in 2017. There is no comparison of its accuracy with other ultrasound formulae. This study aims to compare the accuracy of INTERGROWTH-21 formula in fetal weight estimation with the traditional Hadlock1 and Shepard formula.

巨大胎儿预测方法探讨

目的 探讨巨大胎儿的预测方法。方法 测量408例足月孕妇的宫高,计算以不同的宫高作为截断值筛选巨大胎儿的灵敏度、特异度,选取最优截断值。宫高≥最优截断值者176例,行B超检查,测量胎儿腹围(AC)、小脑横径(CD)、双顶径(BPD),并与新生儿出生体重进行相关分析,经二元线性回归推导出以AC、CD预测胎儿体重(FW)的方程式。应用560例进行临床验证。结果 宫高37cm为筛选巨大胎儿的最优截断值,其灵敏度、特异度分别为88.9％、66.7％。宫高≥37cm者,AC与出生体重的相关性最好,CD次之,偏相关系数分别为0.684 54(P<0.001)、0.221 52(P<0.05);以AC、CD预测(FW=269.6×AC 438.4×CD-7642.8).r=0.67(P<0.001)。经560例临床验证,预测巨大胎儿的灵敏度、特异度分别为83.3％、92.2％。预测体重与实际体重的符合率为82.7％。结论 以宫高初步筛选、再以B超测量胎儿AC、CD预测巨大胎儿,方法简便,且较准确,具有临床使用价值。     

Accuracy of fetal weight estimation by ultrasound in periviable deliveries

Abstract

Objective: To evaluate the accuracy of ultrasound estimated fetal weight (EFW) near viability, and to determine the adequacy of use of EFW in place of birth weight (BWT) for predicting prognosis for infants born near the limit of viability.

Methods: Retrospective chart review of women delivering between 22^0/7 and 25^6/7 weeks gestation (GA) with ultrasound performed within 7 days of delivery. Potentially relevant clinical factors were evaluated regarding their impact on accuracy of EFW. Estimated survival based on BWT and EFW, using an National Institute for Child Health and Human Development (NICHD) algorithm, were compared.

Results: Study included 93 infants. Mean absolute percent difference (accuracy) of EFW for BWT was 9.4% (95%CI 7.4–11.3). There was no correlation between EFW accuracy and BWT, GA, maternal age, or BMI. There was a 3% overestimation of BWT per 100?g decrease in BWT (p?=?0.001). Race, oligohydramnios, parity, smoking, or previous cesarean did not impact EFW accuracy. Mean predicted survival by the NICHD algorithm was 43.1% using BWT; 43.6% using EFW (p?=?0.63). An overestimation of predicted survival (using EFW instead of BWT) greater than 20% was detected in only two cases.

Conclusion: Accuracy is similar to prior studies. Estimated newborn survival based on EFW is similar to that based on BWT.     

Accuracy of sonographic fetal weight estimation of fetuses with a birth weight of 1500 g or less

Objective

To compare 35 commonly used formulae for small and average sized fetuses on their accuracy in estimating the birth weight in fetuses of 1500 g or less.

Study design

For this retrospective study a database search was performed for all singleton pregnancies without structural or chromosomal defects and with a birth weight of 1500 g or less where the last ultrasound examination was performed within seven days before delivery. Percentage error and absolute percentage error were calculated based on 35 different weight estimation formulae. Multiple regression analysis was used to determine the significant contributors to the absolute percentage error.

Results

One hundred and ninety-three cases fulfilled the inclusion criteria. The median birth weight was 990 g. The percentage error ranged between −15.2% (underestimation with the Merz I formula) and 37.4% (overestimation with the Jordaan formula) and the respective standard deviations between 10.5% (Mielke I) and 54.0% (Schillinger), respectively. The absolute percentage error was between 8.5% and 37.6%. The most accurate weight estimation was achieved with the formula from Mielke (percentage error 1.8% and absolute percentage error 8.5%). Multiple regression analysis showed that significant contributors to the percentage error of the Mielke formula were biparietal diameter (OR = −0.206, p = 0.045), occipitofrontal diameter (OR = 0.765, p < 0.0001), abdominal circumference (OR = −2.953, p < 0.0001), femur length (OR = −0.903, p < 0.0001), head to abdomen ratio (OR = −1.080, p < 0.0001) and fetal weight (OR = 2.847, p < 0.0001).

Conclusion

When estimating fetal weight in fetuses weighing 1500 g or less, one has to be aware of the great differences in accuracy among the formulae.     

Prediction of birth weight using fetal thigh and upper-arm volumes by three-dimensional ultrasonography in a Brazilian population

Objective.?To assess the accuracy of three-dimensional (3DUS) upper-arm (VolArm) and thigh (VolTh) volume measurements in the prediction of birth weight (BW).

Methods.?A cross-sectional study involving 81 live singletons was performed. VolArm and VolTh were obtained using 3DUS multiplanar mode with 5?mm slices. Linear and polynomial regressions were calculated to determine the best formula to predict BW using VolArm and VolTh. Analysis of variance was used to compare errors in BW using these formulae and using Shepard's and Hadlock's formulae. The interclass correlation coefficient (ICC) was used to assess intra and interobserver variability of measurements.

Results.?The best formula to predict BW based on VolArm was a simple linear equation (BW?=?803.91?+?39.89VolArm), and for VolTh it was a second degree polynomial equation (BW?=?32.37VolTh ? 0.06VolTh²). A third formula using both parameters was also constructed (BW?=?792.87?+?22.81VolArm?+?7.54VolTh). The error (E), percent error (PE), absolute error (AE) and absolute percent error (APE) for the BW prediction using VolArm were 0?g, 163.4?g, 0.5% and 5.4%, respectively. The same results for E, PE, AE and APE using VolTh were 0.99?g, 155.5?g, 0.3% and 5.2% and for the combined formula using both VolArm and VolTh the E, PE, AE and APE were 0?g, 138.4?g, ?0.4% and 4.6%, respectively. VolArm and VolTh were highly reproducible with intraobserver ICC of 0.98 and 0.99 and interobserver ICC of 0.96 and 0.97, respectively.

Conclusions.?BW estimated through formulae that use the fetal arm and thigh volumes assessed through 3DUS are not superior to two-dimensional formulae.     

Ultrasonic estimation of fetal weight at term: an evaluation of eight formulae

AIM: To compare the accuracy of eight sonographic formulae for predicting fetal birth weight at term in a multiethnic population. METHODS: Pregnant women at term who were booked for induction of labor or elective cesarean section were included in the study. Eight ultrasonic fetal biometric formulae were used to predict fetal birth weight. RESULTS: A total of 173 patients were included in the study; 53 (30.6%) patients were from the Indian subcontinent, 44 (25.4%) patients were from Africa, 33 (19.1%) patients were from the Arabian Peninsula and 43 (24.9%) were from other ethnic groups. The mean absolute error ranged from a minimum of 0.3% (+/-11.3) for Hadlock (biparietal diameter [BPD], head circumference [HC], abdominal circumference [AC], femur length [FL]) to a maximum of 37.5% (+/-10.0) for Warsof (FL). The correlation of estimated fetal weight with actual birth weight ranged from a minimum of 0.09 with Warsof (FL) to a maximum of 0.77 with Shepard and Warsof (BPD, AC) and Hadlock (BPD, HC, AC, FL). The combination of AC with BPD measurements rather than FL achieves a high level of accuracy. CONCLUSIONS: Shepard (BPD, AC) provides a simple and accurate logarithm for the prediction of fetal weight at term in the studied multiethnic population.