Repeated Measurement of Crown-Rump Length at 9 and 11-13 Weeks' Gestation: Association with Adverse Pregnancy Outcome.
Repeated Measurement of Crown-Rump Length at 9 and 11-13 Weeks' Gestation: Association with Adverse Pregnancy Outcome.
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妊娠第 9 周和第 11-13 周时重复测量头臀长度：与不良妊娠结果的关联。
DOI：
10.1159/000381803
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发表时间：
2015
影响因子：
2.2
通讯作者：
Sekizawa A.
中科院分区：
文献类型：
--
作者：
Nakamura M;Hasegawa J;Arakaki T;Takita H;Hamada S;Ichizuka K;Sekizawa A.
目的探讨超声测量孕11~13周胎儿头臀长度(CRL)是否能预测胎儿预后。在妊娠11-13周时测量CRL，在9周时用CRL测定胎儿生长发育。将受试者分为短CRL(S-CRL)和正常CRL(n-CRL)。结果纳入S-CRL组12 6例和n-CRL组1 130例。流产发生率S-慢性粒细胞白血病患者为7.1%，非慢性粒细胞白血病患者为0.9%(p<；0.001)。在有染色体异常的患者中，S-CRL中18三体的发生率显著高于对照组(4.8vs.0.1%，p<；0.001)。在无流产的情况下，胎盘重量、小于胎龄儿的发生率和出生体重S-CRL组显著高于n-CRL组(12.8%vs.3.6%，p<；0.001)。结论9周时测定CRL有助于在11~13周测定CRL之前确定孕天。在9周再次确定孕周后，在11-13周测量CRL有助于预测妊娠后期18三体和SGA的发生率。
AimsTo clarify whether ultrasonographic measurements of crown-rump length (CRL) at 11-13 weeks-based on the number of gestational days determined using the CRL at 9 weeks-can predict fetal prognosis.MethodsA prospective cohort study was conducted to evaluate the association between fetal growth in the first trimester and fetal prognosis. Fetal growth in the first trimester was evaluated measuring CRLs at 11-13 weeks determined using the CRL at 9 weeks. The subjects were divided into short CRL (s-CRL) and normal CRL (n-CRL). The prognoses were compared between the two groups.ResultsA total of 126 patients in the s-CRL group and 1,130 patients in the n-CRL group were enrolled. Abortion occurred in 7.1% of s-CRL and 0.9% of n-CRL subjects (p< 0.001). Among the patients with chromosomal abnormalities, the incidence of trisomy 18 was significantly greater in s-CRL (4.8 vs. 0.1%, p< 0.001). Without abortion, placental weight, frequency of small for gestational age (SGA) and birth weight in s-CRL were significantly higher than those in the n-CRL group (12.8 vs. 3.6%, p< 0.001).ConclusionsMeasuring CRL at 9 weeks is useful for determining gestational days prior to measuring CRL at 11-13 weeks. After reconfirming the gestational age at 9 weeks, measuring CRL at 11-13 weeks is useful for predicting the incidence of trisomy 18 as well as SGA later in pregnancy.