Accuracy of estimated fetal weight assessment in fetuses with abdominal wall defects.
Accuracy of estimated fetal weight assessment in fetuses with abdominal wall defects.
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DOI：
10.1016/j.ajogmf.2021.100385
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发表时间：
2021-07
影响因子：
6.3
通讯作者：
Zuckerwise LC
中科院分区：
文献类型：
--
作者：
Ha LC;Craig A;Grace MR;Osmundson SS;Taylor EW;Zuckerwise LC
腹裂和脐膨出是先天性腹壁缺陷，其中肠和其他腹部内容物从胎儿腹腔中挤出。使用超声估计胎儿体重的标准公式包括胎儿腹围测量，误差范围约为10%。目前尚不清楚是否由于腹部内容物的挤出而影响了腹壁缺陷胎儿的估计胎儿体重评估的准确性。本研究旨在通过比较产前胎儿体重评估与实际出生体重，评估标准估计胎儿体重评估在腹壁缺陷胎儿中的准确性。2012年至2018年，在一家中心对诊断为腹裂或脐膨出的胎儿进行了一项回顾性队列研究。排除具有额外异常或经证实的染色体异常的胎仔。使用Hadlock公式计算估计的胎儿体重。使用已发表的胎儿生长速率估计值，根据最终生长超声确定出生时预计估计胎儿体重，并计算出生时预计估计胎儿体重与实际出生体重之间的差异百分比。使用Wilcoxon秩和检验检查预测的估计胎儿体重与实际出生体重之间的差异。我们有112例腹壁缺损胎儿的完整资料，其中腹裂85例，脐膨出27例。预测的估计胎儿体重中位数（四分位距）与出生体重中位数相似，分别为2283 g（四分位距，2000-2810）和2306 g（四分位距，1991-264），这并不代表预测的估计胎儿体重与实际出生体重之间存在统计学显著差异（P=.32）。中位百分比误差为6.8（3.1-12.8）。此外，我们没有发现腹裂（P= 0.52）或脐膨出（P= 0.35）患者的预计胎儿体重与实际出生体重之间存在任何统计学差异。在大多数病例中估计的胎儿体重被低估（n=68 [60.7%]）。在腹壁缺陷的胎儿中，胎儿体重的标准测量显示的准确性至少与先前建立的超声评估胎儿体重的误差范围相当。标准估计胎儿体重评估仍然是估计这些胎儿体重的适当方法。
Gastroschisis and omphalocele are congenital abdominal wall defects in which the bowel and other abdominal contents extrude from the fetal abdominal cavity. Standard formulas for estimated fetal weight using ultrasound include fetal abdominal circumference measurement and have a range of error of approximately 10%. It is unknown whether the accuracy of estimated fetal weight assessment is compromised in fetuses with abdominal wall defects because of the extrusion of abdominal contents. This study aimed to assess the accuracy of standard estimated fetal weight assessment in fetuses with abdominal wall defects by comparing prenatal assessment of fetal weight with actual birthweight. A retrospective cohort study of fetuses diagnosed with gastroschisis or omphalocele was performed at a single center from 2012 to 2018. Fetuses with additional anomalies or confirmed chromosome abnormalities were excluded. Estimated fetal weight was calculated using the Hadlock formula. Published estimates of fetal growth rate were used to establish a projected estimated fetal weight at birth from the final growth ultrasound, and the percent difference between projected estimated fetal weight at birth and actual birthweight was calculated. The Wilcoxon rank-sum test was used to examine the difference between projected estimated fetal weight and actual birthweight. We had complete data for 112 fetuses with abdominal wall defects, including 85 with gastroschisis and 27 with omphalocele. The median (interquartile range) projected estimated fetal weight was similar to median birthweight, at 2283 g (interquartile range, 2000–2810) and 2306 g (interquartile range, 1991–264), respectively, which did not represent a statistically significant difference between projected estimated fetal weight and actual birthweight (P=.32). The median percent error was 6.8 (3.1–12.8). In addition, we did not find any statistical difference between projected estimated fetal weight and actual birthweight in patients with gastroschisis (P=.52) or omphalocele (P=.35) individually. Estimated fetal weight was underestimated in most cases (n=68 [60.7%]). In fetuses with abdominal wall defects, standard measurement of fetal weight shows an accuracy that is at least comparable with previously established margins of error for ultrasound assessment of fetal weight. Standard estimated fetal weight assessment remains an appropriate method of estimating fetal weight in these fetuses.
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作者：
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