THE HEAD TO ABDOMEN CIRCUMFERENCE RATIO - A REAPPRAISAL
THE HEAD TO ABDOMEN CIRCUMFERENCE RATIO - A REAPPRAISAL
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DOI：
10.1046/j.1469-0705.1995.05040256.x
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发表时间：
1995-04-01
影响因子：
7.1
通讯作者：
BOVICELLI, L
中科院分区：
文献类型：
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作者：
DAVID, C;GABRIELLI, S;BOVICELLI, L
我们的目的是评估超声得出的头腹围比在小胎龄（SGA）胎儿中的临床意义。对134例妊娠26-40周无超声畸形的单胎SGA胎儿进行头腹比测定。收集有关产前监测、脐动脉多普勒测速和新生儿结局的数据。在SGA胎儿中，根据胎龄调整后的头腹比呈正态频率分布，与正常出生体重的胎儿相比呈正偏态。56例SGA胎儿（42%）发现头腹比升高，并与围产期死亡率增加（优势比3.27；95%置信区间1.04-9.34）、出生体重降低（1533 +/- 635 g vs. 2022 +/- 655 g, p < 0.0001）和分娩时胎龄降低（34 +/- 3.6周vs. 36.3 +/- 3.6周，p < 0.005）相关。然而，逻辑回归显示，怀孕结局最重要的产前决定因素是脐动脉的多普勒测速，其次是生物物理特征，而头腹比没有发现独立的相关性。SGA胎儿是否存在“对称型”和“不对称型”这两种不同的类型仍不确定。头腹比升高是妊娠结局的不利危险因素。然而，当脐动脉多普勒测速和产前生物物理检测可用时，该参数没有明确的临床价值。
Our objective was to assess the clinical significance of the sonographically derived head-to-abdomen circumference ratio in small-for-gestational-age (SGA) fetuses. The head-to-abdomen ratio was determined in 134 singleton SGA fetuses without ultrasound evidence of malformations at 26-40 weeks' gestation. Data were collected regarding antenatal surveillance, umbilical artery Doppler velocimetry and neonatal outcome.In SGA fetuses, the head-to-abdomen ratio, adjusted for gestational age, had a normal frequency distribution, positively skewed with regard to fetuses with normal birth weight. An elevated head-to-abdomen ratio was found in 56 SGA fetuses (42%), and was associated with increased perinatal mortality (odds ratio 3.27; 95% confidence internal 1.04-9.34), lower birth weight (1533 +/- 635 g vs. 2022 +/- 655 g, p < 0.0001) and lower gestational age at delivery (34 +/- 3.6 weeks vs. 36.3 +/- 3.6 weeks, p < 0.005). However, logistic regression revealed that the most powerful antenatal determinants of pregnancy outcome were Doppler velocimetry of the umbilical artery, followed by biophysical profile, while no independent correlation was found with the head-to-abdomen ratio.The existence of two distinct categories of SGA fetuses, 'symmetric' and 'asymmetric', remains uncertain. An elevated head-to-abdomen ratio is an adverse risk factor for pregnancy outcome. However, this parameter has no clearcut clinical value when umbilical artery Doppler velocimetry and biophysical antenatal testing are available.