上海交通大学学报（医学版）

上海交通大学学报（医学版） >

2021 , Vol. 41 >Issue 3: 366 - 370

DOI: https://doi.org/10.3969/j.issn.1674-8115.2021.03.014

综述

孕妇及胎儿超声参数评估胎儿体质量的研究进展

  • 王一飞 ,
  • 吴琰婷 ,
  • 黄荷凤
展开
  • 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
王一飞（1994—），女，博士生；电子信箱：wangyifei0524@outlook.com。

收稿日期: 2020-01-27

  网络出版日期: 2021-04-06

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)

收起

Advances in estimating fetal weight by maternal and fetal ultrasound variables

  • Yi-fei WANG ,
  • Yan-ting WU ,
  • He-feng HUANG
Expand
  • 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 date: 2020-01-27

  Online published: 2021-04-06

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)

Fold

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

本文引用格式

王一飞 , 吴琰婷 , 黄荷凤 . 孕妇及胎儿超声参数评估胎儿体质量的研究进展[J]. 上海交通大学学报（医学版）, 2021 , 41(3) : 366 -370 . DOI: 10.3969/j.issn.1674-8115.2021.03.014

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

参考文献

1 Oral E, Ca?da? A, Gezer A, et al. Perinatal and maternal outcomes of fetal macrosomia[J]. Eur J Obstet Gynecol Reprod Biol, 2001, 99(2): 167-171.
2 Boulet SL, Alexander GR, Salihu HM, et al. Macrosomic births in the United States: determinants, outcomes, and proposed grades of risk[J]. Am J Obstet Gynecol, 2003, 188(5): 1372-1378.
3 Menticoglou S. Shoulder dystocia: incidence, mechanisms, and management strategies[J]. Int J Womens Health, 2018, 10: 723-732.
4 Vitner D, Bleicher I, Kadour-Peero E, et al. Does prenatal identification of fetal macrosomia change management and outcome?[J]. Arch Gynecol Obstet, 2019, 299(3): 635-644.
5 Bushman ET, Thompson N, Gray M, et al. Influence of estimated fetal weight on labor management[J]. Am J Perinatol, 2020, 37(3): 252-257.
6 Dudley NJ. A systematic review of the ultrasound estimation of fetal weight[J]. Ultrasound Obstet Gynecol. 2005, 25(1): 80-89.
7 De Myttenaere A, Golden B, Le Grand B, et al. Using the mean absolute percentage error for regression models[J/OL]. [2020-01-26]..
8 Willmott CJ, Matsuura K. Advantages of the mean absolute error (MAE) over the root mean square error (RMSE) in assessing average model performance[J]. Clim Res, 2005, 30(1): 79-82.
9 Hyndman RJ, Koehler AB. Another look at measures of forecast accuracy[J]. Int J Forecast, 2006, 22(4): 679-688.
10 顾国华, 陈千娣, 姚家生. 预测胎儿体重的探讨(附400例分析)[J]. 实用妇科与产科杂志, 1987, (2): 93.
11 Numprasert W. A study in Johnson's formula: fundal height measurement for estimation of birth weight[J]. AU J. T., 2004, 8(1): 15-20.
12 胡章和, 田孝坤. 110例头位难产的初步分析[J]. 中级医刊, 1983, (1): 18-20.
13 刘旦光, 汪应志, 朱从容, 等. 足月新生儿体重预测的探讨: 附715例分析[J]. 中华妇产科杂志, 1985, 20(4): 243-244.
14 徐朗澄, 罗美瑜, 林亭亭, 等. 预测胎儿体重的新方法[J]. 福建医药杂志, 1984, (2): 44-45.
15 Mgbafulu CC, Ajah LO, Umeora OUJ, et al. Estimation of fetal weight: a comparison of clinical and sonographic methods[J]. J Obstet Gynaecol, 2019, 39(5): 639-646.
16 Hadlock FP, Harrist RB, Sharman RS, et al. Estimation of fetal weight with the use of head, body, and femur measurements: a prospective study[J]. Am J Obstet Gynecol, 1985, 151(3): 333-337.
17 Warsof SL, Gohari P, Berkowitz RL, et al. The estimation of fetal weight by computer-assisted analysis[J]. Am J Obstet Gynecol, 1977, 128(8): 881-892.
18 Shepard MJ, Richards VA, Berkowitz RL, et al. An evaluation of two equations for predicting fetal weight by ultrasound[J]. Am J Obstet Gynecol, 1982, 142(1): 47-54.
19 Hammami A, Zumaeta AM, Syngelaki A, et al. Ultrasonographic estimation of fetal weight: development of new model and assessment of performance of previous models[J]. Ultrasound Obstet Gynecol, 2018, 52(1): 35-43.
20 Sabbagha RE, Minogue J, Tamura RK, et al. Estimation of birth weight by use of ultrasonographic formulas targeted to large-, appropriate-, and small-for-gestational-age fetuses[J]. Am J Obstet Gynecol, 1989, 160(4): 854-862.
21 Robson SC, Gallivan S, Walkinshaw SA, et al. Ultrasonic estimation of fetal weight: use of targeted formulas in small for gestational age fetuses[J]. Obstet Gynecol, 1993, 82(3): 359-364.
22 Jouannic JM, Grangé G, Goffinet F, et al. Validity of sonographic formulas for estimating fetal weight below 1 250 g: a series of 119 cases[J]. Fetal Diagn Ther, 2001, 16(4): 254-258.
23 Sokol RJ, Chik L, Dombrowski MP, et al. Correctly identifying the macrosomic fetus: improving ultrasonography-based prediction[J]. Am J Obstet Gynecol, 2000, 182(6): 1489-1495.
24 Hart NC, Hilbert A, Meurer B, et al. Macrosomia: a new formula for optimized fetal weight estimation[J]. Ultrasound Obstet Gynecol, 2010, 35(1): 42-47.
25 Chauhan SP, West DJ, Scardo JA, et al. Antepartum detection of macrosomic fetus: clinical versus sonographic, including soft-tissue measurements[J]. Obstet Gynecol, 2000, 95(5): 639-642.
26 Bernstein IM, Catalano PM. Influence of fetal fat on the ultrasound estimation of fetal weight in diabetic mothers[J]. Obstet Gynecol, 1992, 79(4): 561-563.
27 Zelop CM. Prediction of fetal weight with the use of three-dimensional ultrasonography[J]. Clin Obstet Gynecol, 2000, 43(2): 321-325.
28 陈伟, 蔡辰, 张妍, 等. 上海市松江区妇女孕期增重与妊娠结局的关系[J]. 上海交通大学学报(医学版), 2018, 38(12): 1479-1483.
29 Cromi A, Ghezzi F, Di Naro E, et al. Large cross-sectional area of the umbilical cord as a predictor of fetal macrosomia[J]. Ultrasound Obstet Gynecol, 2007, 30(6): 861-866.
30 Hackmon R, Bornstein E, Ferber A, et al. Combined analysis with amniotic fluid index and estimated fetal weight for prediction of severe macrosomia at birth[J]. Am J Obstet Gynecol, 2007, 196(4): 333.e1-e4.
31 Benacerraf BR, Gelman R, Jr Frigoletto FD. Sonographically estimated fetal weights: accuracy and limitation[J]. Am J Obstet Gynecol, 1988, 159(5): 1118-1121.
32 沈敏, 谈韬, 李浩捷, 等. 胎盘质量与新生儿出生体质量的相关性研究[J]. 上海交通大学学报(医学版), 2019, 39(8): 893-897.
33 Lee W, Comstock CH, Kirk JS, et al. Birthweight prediction by three-dimensional ultrasonographic volumes of the fetal thigh and abdomen[J]. J Ultrasound Med, 1997, 16(12): 799-805.
34 Schild RL, Fimmers R, Hansmann M. Can 3D volumetric analysis of the fetal upper arm and thigh improve conventional 2D weight estimates?[J]. Ultraschall Med, 1999, 20(1): 31-37.
35 Schild RL, Fimmers R, Hansmann M. Fetal weight estimation by three-dimensional ultrasound[J]. Ultrasound Obstet Gynecol, 2000, 16(5): 445-452.
36 Baker PN, Johnson IR, Gowland PA, et al. Fetal weight estimation by echo-planar magnetic resonance imaging[J]. Lancet, 1994, 343(8898): 644-645.
37 Uotila J, Dastidar P, Heinonen T, et al. Magnetic resonance imaging compared to ultrasonography in fetal weight and volume estimation in diabetic and normal pregnancy[J]. Acta Obstet Gynecol Scand, 2000, 79(4): 255-259.
38 Farmer RM, Medearis AL, Hirata GI, et al. The use of a neural network for the ultrasonographic estimation of fetal weight in the macrosomic fetus[J]. Am J Obstet Gynecol, 1992, 166(5): 1467-1472.
39 Chuang L, Hwang JY, Chang CH, et al. Ultrasound estimation of fetal weight with the use of computerized artificial neural network model[J]. Ultrasound Med Biol, 2002, 28(8): 991-996.
40 李昆, 柴玉梅, 赵红领, 等. 基于深度神经网络的胎儿体重预测[J]. 计算机科学, 2016, 43(S2): 73-76, 82.
41 朱海龙, 陶晶, 俞凯, 等. 基于GA-BP神经网络的胎儿体重预测分析[J]. 计算机系统应用, 2018, 27(3): 162-167.
Options
文章导航

/

〈 〉