Utility of Head/Abdomen Circumference Ratio in the Evaluation of Severe Early-Onset Intrauterine Growth Restriction
Utility of Head/Abdomen Circumference Ratio in the Evaluation of Severe Early-Onset Intrauterine Growth Restriction
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DOI：
10.1016/s1701-2163(16)34956-8
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发表时间：
2011-07-01
影响因子：
1.8
通讯作者：
Kingdom, John C. P.
中科院分区：
文献类型：
--
作者：
al Riyami, Nihal;Walker, Melissa G.;Kingdom, John C. P.
目的：为了确定胎儿宫内生长受限（IUGR）的主要表型是对称还是不对称的严重，早发性疾病由于胎盘insufficient.Methods：我们进行了一项回顾性图表审查的高危孕妇严重，早发性IUGR谁交付在< 33+0周的妊娠在西奈山医院从2001年至2010年。在分娩后7天内对超声图像进行胎儿生物统计学、羊水量、子宫和脐部多普勒血流研究，并确定头围/腹围比值>=妊娠第95百分位数的频率。107例早发IUGR孕妇中有62例（58%）HC/AC比值升高（>=第95百分位数），比预期比例高10倍以上（P < 0.001）。重度子痫前期（53%），羊水异常（70%），异常子宫动脉多普勒研究（78%）表明胎盘功能不全。结论：胎儿与重度胎盘IUGR在孕中期更可能有一个不对称的表型。这与目前认为不对称IUGR仅限于妊娠晚期IUGR的观点相反。
Objective: To determine whether the predominant phenotype of intrauterine growth restriction (IUGR) is symmetric or asymmetric in severe, early-onset disease due to placental insufficiency.Methods: We conducted a retrospective chart review of high-risk pregnant women with severe, early-onset IUGR who were delivering at < 33+0 weeks' gestation at Mount Sinai Hospital from 2001 to 2010. Ultrasound images were reviewed for fetal biometry, amniotic fluid volume, and uterine and umbilical Doppler flow studies within seven days of delivery, and the frequency of head circumference/abdominal circumference ratio >= 95th percentile for gestation was determined.Results: Sixty-two of 107 pregnancies (58%) with early-onset IUGR had an elevated HC/AC ratio (>= 95th percentile), which was more than 10-fold greater than the expected proportion (P < 0.001). High rates of severe preeclampsia (53%), abnormal amniotic fluid (70%), and abnormal uterine artery Doppler studies (78%) indicated placental insufficiency.Conclusion: Fetuses with severe placental IUGR in the second trimester are more likely to have an asymmetric phenotype. This is in contrast to the current belief that asymmetric IUGR is confined to third trimester IUGR.