选择性查超声波的性能,以检测妊娠年龄小的胎儿:在DESiGN随机对照试验中嵌入的前性队列研究
Charles Arcus1, James Elhindi1, Chivon Winsloe2
1Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
概括
胎儿体重 (EFW) 的超声波估计低于第10百分位,在怀孕晚期检测小至妊娠年龄 (SGA) 胎儿时很差,特别是在出生前更长的间隔时.
科学领域:
- 产科和妇科 产科和妇科
- 胎儿医学 胎儿医学
- 诊断性的超声波检查
背景情况:
- 检测较小的妊娠年龄 (SGA) 胎儿对于改善围产期结果至关重要.
- 关于胎儿生长超声波参数在特定人群中SGA检测的准确性的证据有限.
研究的目的:
- 评估估计胎儿体重 (EFW) 在最后一次选择性查超声波检测SGA时低于第10百分位的表现.
- 评估扫描时的妊娠年龄和扫描与分娩之间的间隔如何影响EFW性能.
主要方法:
- 一项前性队列研究,分析了DESiGN试验中的数据.
- 包括94,925名妇女,在怀孕24周后至少进行一次超声波扫描.
- 计算了EFW<10百分位数的测试性能特征,以预测出生体重<10百分位数.
主要成果:
- 在识别SGA时EFW<第10百分位的准确性从怀孕34周开始下降.
- 对于在怀孕34周到37周+6周之间进行的扫描,在出生前4周以上的间隔内进行的扫描,性能特别差 (灵敏度为4.0%).
结论:
- 胎儿尺寸的第三季度末期超声波估计在特定人群中在出生时检测SGA的表现不佳.
- 精度受到扫描时间和交付间隔的显著影响.
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