上海交通大学学报(医学版)

• 论著(临床研究) • 上一篇    下一篇

超声在预测双胎妊娠新生儿出生体质量差异中的价值

孙金铃1,牛建梅1,高佳琪2,吕淑平3,王彦林3   

  1. 上海交通大学 医学院附属国际和平妇幼保健院1. 超声影像科,2. 生殖遗传科,3. 产前诊断中心,上海 200030
  • 出版日期:2017-04-28 发布日期:2017-05-04
  • 通讯作者: 王彦林,电子信箱:wyanlin@163.com
  • 作者简介:孙金铃(1985—),女,硕士生;电子信箱:sunjinling4102@163.com。
  • 基金资助:

    上海市科学技术委员会基金(16411962800)

Value of ultrasonography in predicting the birth weight discordance of twin pregnancy

SUN Jin-ling1, NIU Jian-mei1, GAO Jia-qi2, Lü Shu-ping3, WANG Yan-lin3   

  1. 1. Department of Ultrasound, 2. Department of Reproductive Genetics, 3. Prenatal Diagnosis Center, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Online:2017-04-28 Published:2017-05-04
  • Supported by:

    Foundation of Science and Technology Commission of Shanghai Municipality, 16411962800

摘要:

目的 ·研究胎儿估计体质量(EFW)差异与新生儿出生体质量(BW)差异间的关系,评估超声预测双胎妊娠的新生儿出生体质量差异(Δ BW)的准确性。方法
·应用超声检测不同孕周双胎的生长参数,对各项参数进行统计学分析,探讨EFW差异(Δ EFW)与Δ BW之间的关系。结果 ·在277对双胎中,44对双胎(15.9%)存在2个胎儿Δ BW ≥20%。该现象在双绒毛膜双羊膜囊双胎(DCDA)与单绒毛膜双羊膜囊双胎(MCDA)的发生率分别为68.2%和31.8%,两者差异无统计学意义(P>0.01)。与孕期其他孕周评估的Δ EFW相比,分娩前末次超声评估的Δ EFW与Δ BW一致性最佳。在MCDA中,孕22~24周超声评估Δ EFW的阴性预测值最高(94%)。结论 ·双胎妊娠胎儿出生前末次超声评估的Δ EFW与Δ BW的一致性最高。对超声未发现Δ EFW较大即Δ EFW<20%的双胎,尤其是孕
22~24周阶段MCDA中Δ EFW<20%者,其未来发生选择性宫内生长受限(sIUGR )机会较小。

关键词: 超声, 双胎妊娠, 估计胎儿体质量差异, 出生体质量差异, 双绒毛膜双羊膜囊双胎, 单绒毛膜双羊膜囊双胎

Abstract:

 Objective · To identify the relationship between the estimated fetal weight (EFW) discordance and birth weight (BW) discordance, and evaluate the accuracy of ultrasonography in predicting birth weight discordance (ΔBW) of twin pregnancy. Methods · The ultrasound was used to detect the growth of twins at different gestational weeks and the data were analyzed to compare the difference between EFW discordance (ΔEFW) and ΔBW. Results · About 15.9 percent of twins (totally 277 cases) had severe ΔBW (ΔBW ≥20%) in our study, and the percentages of dichorionic-diamniotic twin (DCDA) and monochorionic-diamniotic twin (MCDA) were 68.2% and 31.8%, respectively (P>0.01). Compared with ΔEFW in other gestational weeks, ΔEFW last time before parturition was most consistent of ΔBW. Furthermore, the negative predictive value of MCDA was highest (94%) at 22–24 gestational weeks. Conclusion · Twin ΔBW was relatively better predicted by ΔEFW last time before parturition. Twin pregnancy without severe ΔEFW (ΔEFW<20%), especially MCDA with ΔEFW<20% at 22–24 weeks, had low probability of selective intrauterine growth restriction in the future.

Key words: ultrasound, twin pregnancy, estimated fetal weight discordance, birth weight discordance, dichorionic-diamniotic twin, monochorionicdiamniotic twin