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。

Macrosomia Prediction Using Ultrasound Measurement of Fetal Abdominal Circumference

Objective To determine the relative factors in predicting birthweight and to evaluate the usefulness of the fetal abdominal circumference measurement by ultrasound in prediction of macrosomia. Methods One hundred and forty eight pregnant women whose sum of the fundus height plus the abdominal circumference was greater than 135 cm were chosen, the biparietal diameter (BPD), abdominal circumference (FAC), femus length (FL) of their fetus within 3 days before delivery were measured by ultrasound. At the same time, the fundus height of the uterus、 abdominal circumference、 the gestational age、 the body weight gain during pregnancy、 and the body height of the mother were obtained. Stepwise multiple regression analysis was used to determine the relation ship between birth weight and these factors. According to the birth weight two groups were divided, macrosomic and nonmacrosomic group. The characters of the two groups were compared. Results The best linear predictor of birth weight was ultrasound measurement of fetal abdominal circumference (FAC), which had a correlation coefficient of 0.85. An FAC of 36 cm or more can predict 82% of macromic infants. The cesarean section rate of the macrosomic group was 70.2%. Conclusions Fetal abdominal circumference measurement by ultrasound is the best predictor of birth weight among the parameters. FAC is useful in screening for suspected macrosomia.