胎儿生长发育受限的超声诊断与监测

胎儿生长受限指因胎盘功能不全导致胎儿生长未能达到其生物学潜能。目前临床最大困惑是如何鉴别胎儿生长受限与健康小于胎龄儿。超声为诊断胎儿生长受限的金标准，主要诊断指标包括估重、腹围及脐动脉血流频谱。超声监测有助于预测胎儿不良结局，协助判断分娩时机。目前已被证明可帮助评估患儿预后的监测指标包括估重、腹围等生长径线、脐动脉血流阻力指数、静脉导管血流频谱、大脑中动脉频谱、脑胎盘血流比率、子宫动脉血流阻力指数。

Ultrasonic diagnosis and monitoring of fetal growth restriction

Fetal growth restriction (FGR) is defined as the fetus does not reach its biological growth potential as a consequence of impaired placental function. Currently, the biggest clinical problem in this field is how to distinguish FGR fetus from healthy small for gestational age (SGA) fetus. Ultrasonography was regarded as golden criteria in diagnosis of FGR. The key diagnostic indexes included abdominal circumference (AC), estimated fetal weight (EFW) and umbilical artery (UA) blood flow spectrum curve. Ultrasonic monitoring can help to predict the adverse perinatal outcomes and select the optimal time of delivery. Some monitoring indexes, including growth parameters such as EFW and AC, resistance index of UA, ductus venosous Doppler waveform, middle cerebral artery, cerebroplacental ratio, as well as resistance index of uterine artery have been proved to be helpful to monitoring and prognosis of FGR.