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通过使用z-分数来选择超声波胎儿头周长标准
C Andrew Combs1,2, Amber Del Rosario2, Olaide Ashimi Balogun3
1Pediatrix Center for Research, Education, Quality and Safety, Pediatrix Medical Group, Sunrise, Florida.
American journal of perinatology
|July 24, 2023
概括
世界卫生组织 (WHO) 的标准最适合胎儿头周长 (HC) 测量,用于诊断异常的HC. 其他标准,如Jeanty (Chervenak) 显示微头症查的敏感性较差.
科学领域:
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 产前超声波检查 产前超声波检查
- 胎儿成长评估 胎儿成长评估
背景情况:
- 精确的胎儿头周长 (HC) 测量对于评估胎儿生长和检测异常至关重要.
- 对于超声波HC评估存在多个既定的规范,这导致了对临床实践最佳选择的不确定性.
研究的目的:
- 评估和比较五个已建立的规范的适应性,以测量胎儿头部周长 (HC) 的超声波测量.
- 确定在一个大队伍中诊断异常胎儿HC的最合适的规范.
主要方法:
- 一项横截面研究分析了22至39周妊娠期间单胎胎儿的23,565次超声检查.
- 五个HC规范 (Jeanty,Hadlock,INTERGROWTH-21st,WHO,NICHD-U) 通过使用统计标准,包括z-score分布和百分点分析,评估了它们的适合性.
主要成果:
- 世界卫生组织 (WHO) 的标准证明最适合研究的HC测量,平均z-score为0.10和SD为1.01.
- 吉恩蒂参考表现出一个大的SD,导致低诊断异常HC,而IG-21st和NICHD-U低估了小HC.
- 哈德洛克参考结果导致了小HC的过度诊断.
结论:
- 世卫组织的标准被推为诊断异常胎儿头周长 (HC) 最合适的标准.
- 由母胎医学学会建议的Jeanty (Chervenak) 参考结果显示,对小头症查的敏感性不足.
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