临床和超声联合预测巨大儿指标评价  

Prediction of fetal macrosomia:evaluation of the combined application of ultrasound and clinical measurement

作　　者：雷丽[1] 王雪燕[1] 高燕[1] 刘菊莲[1] 冯丽娟[1] 

机构地区：[1]重庆市妇幼保健院产科,400010

出　　处：《重庆医学》2014年第23期3014-3016,共3页Chongqing medicine

摘　　要：目的探讨临床和超声预测巨大儿的敏感指标。方法选择本院2012年5-11月住院分娩单胎的孕妇1 037例为研究对象,分娩前3d测量孕妇宫高、腹围,超声测量胎儿径线包括双顶径（BPD）、股骨长（FL）、头围（HC）、腹围（AC）。以预测体质量与实际体质量绝对误差小于或等于250g为符合,将宫高＋腹围初筛巨大儿,然后分别计算单个AC、HC、FL、BPD参数的回归公式,分别计算诊断符合率。结果宫高＋AC大于134cm时,初筛巨大儿诊断指数最高,其ROC曲线下面积为0.895。联合超声胎儿AC,巨大儿的诊断预测率最高为75.2%;胎儿AC≥37cm,巨大儿发生率可达91.7%。结论孕妇宫高＋AC〈134cm,巨大儿可能性不大;宫高＋AC≥134cm,联合超声胎儿AC〉36cm,特别是AC≥37cm巨大儿可能性非常大。Objective To investigate the relativity for weight of macrosomia predicted by ultrasound and clinical measurements.Methods 1 037 subjects who were delivered in May to November 2012,in Chongqing Health Center for Women and Children,were collected and analyzed satistically.The parameters for the comparisons included maternal abdominal circumference（MAC）,fundal height（FH）,and fetal diameters measured by ultrasonic imaging such as biparietal diameter（BPD）,head circumference（HC）,femur length（FL）,and abdominal circumference（AC）.The coincidence was calculated with real weights and compared with clinical predictions.Results When FH＋MAC 134 cm,the accuracy of preliminary screening for macrosomia is the highest,the area under the ROC curve is 0.895.Combining with the abdominal circumference（AC）by prenatal ultrasound,the highest prediction rate of macrosomia is 75.2%.when Fetal AC≥37cm,macrosomia incidence rate took 91.7%.Conclusion Pregnant women with FH＋MAC134cm,whose incidence of Macrosomia is low.While if the FH＋MAC≥134cm,combining with the prenatal ultrasound whose fetal AC36cm,especially≥37cm,the possibility of macrosomia is very high.

关 键 词：巨大儿 宫高 腹围 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.7[医药卫生—诊断学]