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肥胖患者的第一季度解剖学超声波:一种随机对照试验
Cara Buskmiller1, Michal Fishel Bartal2, Miguel Bonilla1
1Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (Drs Buskmiller and Fishel Bartal, Mr Bonilla, Mses Denham and Nguyan, and Drs Sibai and Hernandez-Andrade).
American journal of obstetrics & gynecology MFM
|September 5, 2023
概括
第一个三个月的胎儿解剖学超声波扫描对于肥胖患者 (体重指数≥35公斤/米2) 比第二个三个月的扫描更有效. 早期的超声波成像可以改善胎儿整体解剖学的评估.
科学领域:
- 医疗成像医学成像
- 产科和妇科 产科和妇科
- 胎儿医学 胎儿医学
背景情况:
- 第二个三个月的超声波是美国胎儿解剖评估的标准.
- 国际指导方针表明,对肥胖患者来说,第一季度的时间可能更好.
- 第一个三个月的成像显示出肥胖群体的良好表现.
研究的目的:
- 为了比较第一季度与第二季度胎儿解剖学超声波扫描的完成率.
- 为了评估怀孕个体体质量指数 (BMI) ≥35 kg/m2的妊娠个体的扫描完成.
主要方法:
- 在怀孕14周之前,随机对照试验招募了BMI≥35kg/m2的参与者.
- 随机选择为第一季度 (12~14周) 或第二季度 (18~22周) 的解剖学超声波扫描.
- 主要结果:对所有所需的胎儿结构进行最佳成像的完成率;次要结果:需要通过阴道的方法,视图完成,异常检测,扫描持续时间,患者的观点.
主要成果:
- 66%的第一季度扫描完成,而第二季度扫描完成的比例为53%.
- 结合第一和第二季度的超声波方法实现了76%的完成率.
- 第一个三个月的扫描在63%的病例中需要经阴道的方法,并且更长.
- 两组都没有错过任何异常;患者对第一季度扫描感到满意.
结论:
- 与单次第二季度扫描相比,单次第一季度解剖学超声波更有可能在BMI≥35kg/m2的孕妇中获得所有推的视图.
- 结合第一和第二季度的评估,可以提前4周进行完整的解剖评估.
- 需要进一步评估超声波持续时间的临床可行性.
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