论文部分内容阅读
目的:探讨超声测量胎儿骨骺次级骨化中心和胎盘分级对评估孕龄和胎肺成熟度的临床意义。方法:前瞻性研究从359例孕龄准确的单胎孕妇中获得的518人次超声检查结果,分析胎儿股骨远端次级骨化中心(DFSOC)、胫骨近端次级骨化中心(PTSOC)和胎盘分级与孕龄的关系。选取其中在分娩前1周内接受超声检查且资料完整的184例孕妇,根据新生儿是否发生呼吸窘迫综合征(RDS)分为RDS组(15例)和non-RDS组(169例)。比较两组的DFSOC和PTSOC显示率及胎盘分级情况,并采用Logistic回归分析校正孕周影响,了解DFSOC、PTSOC和胎盘分级与出生后发生RDS的相关性。结果:(1)DFSOC、PTSOC和胎盘分级与超声检查孕周之间均呈正相关,Spearman相关系数分别为0.831、0.716和0.859(P均<0.001)。(2)DFSOC、PTSOC和胎盘Ⅰ级以上分别预示胎儿至少已32周、37周和35周的准确度高达88.03%、89.58%和91.51%。(3)RDS组和non-RDS组的DFSOC、PTSOC显示率及胎盘分级比较,差异均有统计学意义(P均<0.001);但校正分娩孕周的影响后,三者与出生后的RDS的发生均无显著相关性(P>0.05)。结论:胎儿DFSOC、PTSOC和胎盘分级有助于临床上评估某些关键的孕龄,但并不是评估胎肺成熟度的可靠指标。
OBJECTIVE: To investigate the clinical significance of measuring epiphyseal secondary ossification center and placental grading to evaluate gestational age and fetal lung maturity. METHODS: A prospective study of 518 sonographic findings obtained from 359 pregnant women with single gestational age was performed prospectively to analyze the relationship between fetal distal secondary ossification center (DFSOC), proximal tibial secondary ossification center (PTSOC) and Relationship between placental grading and gestational age. One hundred and eighty-four pregnant women, who underwent ultrasound examination within 1 week before delivery, were selected and divided into RDS group (n = 15) and non-RDS group (n = 169) according to whether newborns developed respiratory distress syndrome (RDS). The DFSOC and PTSOC rates and placental grading were compared between the two groups. Logistic regression was used to analyze the effect of gestational age. The correlation between DFSOC, PTSOC, placental grading and postnatal RDS was analyzed. Results: (1) There was a positive correlation between DFSOC, PTSOC, placenta grading and gestational age of ultrasound examination. Spearman correlation coefficients were 0.831, 0.716 and 0.859 respectively (all P <0.001). (2) The accuracy of DFSOC, PTSOC and placenta level Ⅰ and above of the placenta respectively predicted the accuracy of the fetus reached 88.03%, 89.58% and 91.51% for at least 32 weeks, 37 weeks and 35 weeks respectively. (3) There were significant differences in DFSOC, PTSOC display rate and placental grading between RDS group and non-RDS group (all P <0.001); however, after adjusting for gestational age, No significant correlation (P> 0.05). CONCLUSIONS: Fetal DFSOC, PTSOC, and placenta grading help to clinically assess some of the key gestational age, but are not reliable indicators of fetal lung maturity.