上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (3): 366-370.doi: 10.3969/j.issn.1674-8115.2021.03.014

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孕妇及胎儿超声参数评估胎儿体质量的研究进展

王一飞1,2(), 吴琰婷3, 黄荷凤1,3()   

  1. 1.上海交通大学医学院附属国际和平妇幼保健院妇产科,上海 200030
    2.上海市胚胎源性疾病重点实验室,上海 200030
    3.复旦大学附属妇产科医院生殖与发育研究院,上海 200021
  • 收稿日期:2020-01-27 出版日期:2021-03-28 发布日期:2021-04-06
  • 通讯作者: 黄荷凤 E-mail:wangyifei0524@outlook.com;huanghefg@sjtu.edu.cn
  • 作者简介:王一飞(1994—),女,博士生;电子信箱:wangyifei0524@outlook.com
  • 基金资助:
    国家重点研发计划(2017YFC1001300);国家自然科学基金中加国际合作项目(81661128010);上海交通大学中国医学科学院创新单元(2019RU056);上海市卫生健康委员会项目(201840210);上海申康医院发展中心项目(SHDC12018X17)

Advances in estimating fetal weight by maternal and fetal ultrasound variables

Yi-fei WANG1,2(), Yan-ting WU3, He-feng HUANG1,3()   

  1. 1.Department of Obstetrics and Gynaecology, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
    2.Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
    3.Institute of Reproductive and Development, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
  • Received:2020-01-27 Online:2021-03-28 Published:2021-04-06
  • Contact: He-feng HUANG E-mail:wangyifei0524@outlook.com;huanghefg@sjtu.edu.cn
  • Supported by:
    National Key Research and Development Program of China(2017YFC1001300);China and Canada International Cooperation Project of National Nature Science Foundation of China(81661128010);Chinese Academy of Medical Sciences Research Unit, Shanghai Jiao Tong University(2019RU056);Project of Shanghai Municipal Health Commission(201840210);Project of Shanghai Shenkang Hospital Development Center(SHDC12018X17)

摘要:

分娩前使用孕妇及胎儿各项参数计算胎儿估计体质量(estimated fetal weight,EFW)对正确评估胎儿宫内生长发育和妊娠结局有重要的作用。计算EFW的方法种类繁多。使用孕妇参数估计EFW的预测准确率取决于医师的经验和测量的规范性。以产前胎儿超声检查参数为主的Hadlock公式等评估方法是目前临床应用较广泛的方法,但误差仍较大。而通过三维超声和核磁共振对胎儿体积的计算虽可更准确地计算EFW,但受到时间和经济因素的限制,不能被广泛地应用。基于神经网络分析的大数据建模,预测符合率优于传统超声检测,有望成为更好的EFW评估方法。综上,精确评估EFW,并应用于产科临床仍是未来的重大挑战。

关键词: 胎儿体质量, 出生体质量, 超声, 巨大儿, 胎儿生长受限

Abstract:

The estimated fetal weight (EFW), using the parameters of pregnant woman and fetuse before birth, plays an important role in helping evaluating fetal development and pregnancy outcome. Various methods have been used to calculate EFW. Predictive accuracy of estimating EFW by using pregnant women's parameters depends on doctors' experience and standardization of measurement. Some appraisal procedures, such as Hadlock formula, which mainly focus on prenatal fetal ultrasound parameters, have been widely used in clinics but still have large errors. Measurements of fetal volume by 3-dimentional ultrasound and magnetic resonance imaging methods show significant improvements, yet they cannot be widely used because of time and economic issues. The prediction coincidence rate of a model with big data based on analysis of neural network, is better than that of traditional ultrasonic detection. It could be a better method of EFW in the future. In summary, accurate evaluation of EFW and its application to obstetric clinic are still major challenges in the future.

Key words: fetal weight, birth weight, ultrasound, macrosomia, fetal growth restriction

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