超聲測量晚孕期正常雙胎生長參數的初步分析_《華西醫學》

作者：

王晶 ,  楊太珠

四川大學華西第二醫院超聲科（成都，610041）;

關鍵詞：

超聲檢查雙胎胎兒發育小腦橫徑

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【摘要】　目的　擬初步建立孕28~34周的雙胎胎兒生長參數超聲測量值的正常范圍，比較晚孕期單、雙胎妊娠胎兒的宮內生長發育模式。　方法　對2009年5月-2010年4月超聲診斷為正常宮內雙活胎、單活胎孕婦，采用超聲測量胎兒相關生長發育指標，包括雙頂徑、頭圍、腹圍、股骨長等，測量其中部分雙胎的小腦橫徑并應用虛擬器官計算機輔助分析技術測量其小腦容積，比較晚孕期單、雙胎胎兒生長發育的差異。　結果　 ①自妊娠30周以后，雙胎胎兒的雙頂徑發育速度比單胎胎兒延緩，單、雙胎胎兒平均每周增長分別約2.3、1.7 mm；②自妊娠32周以后，雙胎胎兒的頭圍的發育速度比單胎胎兒延緩，單、雙胎胎兒平均每周增長分別約6.7、5.8 mm；③自妊娠30周以后，雙胎胎兒的腹圍的發育速度比單胎胎兒延緩，單、雙胎胎兒平均每周增長分別約6.9、5.3 mm；④雙胎胎兒股骨長從孕28~34周發育速度均較單胎胎兒緩慢，單、雙胎胎兒平均每周增長分別約2.0、1.7 mm；⑤多元分析孕28~34周的雙胎胎兒雙頂徑、頭圍、腹圍和股骨長，相對于單胎胎兒而言，自28周起，雙胎妊娠胎兒的生長發育較延緩；⑥自孕28~34周，雙胎胎兒小腦橫徑、小腦容積與單胎胎兒無明顯差異。　結論　雙胎妊娠胎兒與單胎妊娠胎兒在晚孕期有著不同的生長發育規律。
【Abstract】　Objective　 To initially establish the growth parameters of normal twin pregnancy in 28-34 gestational ages according to the ultrasound measurement, and to compare the intrauterine growth patterns between the singleton and twin pregnancy.　Methods　 The relevant index of the twin pregnancy, including the biparietal diameter (BPD), femur length, head circumference (HC), abdominal circumference (AC), were measured. The transverse cerebellar diameter (TCD) was measured and the virtural organ computer-aided analysis was used to detect the fetal cerebellar volume (FCV). The intrauterine growth patterns between the singleton and twin pregnancy was compared.　Results　 After the gestational age of 30 weeks, the mean values of BPD of the twins pregnancies (1.7 mm) were lower than those of the singleton pregnancies (2.3 mm). After the gestational age of 32 weeks, the mean value of HC of the twins pregnancies (5.8 mm) was lower than that of the singleton pregnancies (6.7 mm). After the gestational age of 30 weeks, the mean values of AC of the twins pregnancies (5.3 mm) were lower than those of the singleton pregnancies (6.9 mm). After the gestational age of 28 weeks, the mean value of FL of the twins pregnancies (1.7 mm) was lower than the singleton pregnancies (2.0 mm). After the gestational age of 28 weeks, the growth of twin pregnancy fetuses is more slowly. After the gestational age of 28-34 weeks, the differences in mean values of TCD and FCV between the twin pregnancy and singleton pregnancy was not significant.　Conclusion　 The twin pregnancy and singleton pregnancy have different growth patterns in the third trimester pregnancy.

引用本文： 王晶,楊太珠. 超聲測量晚孕期正常雙胎生長參數的初步分析. 華西醫學, 2011, 26(10): 1521-1524. doi: 復制

1.	劉蓉, 譚金秀, 陳其能, 等. B超監測雙胎與單胎中晚期妊娠胎兒生長發育的比較[J]. 中國婦幼保健, 2007, 22(18): 2538-2539.
2.	譚金秀. B超測量小腦橫徑監護胎兒生長發育[J]. 湖南醫學, 1993, 10(5): 262-263.
3.	童放, 胡建群, 夏澤, 等. 三維超聲體積自動測量技術測量胎兒小腦體積及與孕齡的相關性研究[J]. 南京醫科大學學報（自然科學版）, 2008, 28(1): 94-96.
4.	陳安珍. 雙胎妊娠胎兒發育及適宜分娩孕周的臨床研究[J]. 中國實用醫藥, 2008, 3(27): 1-2.
5.	司徒夏印, 黃醒華. 單項超聲測量指標預測胎兒體重的臨床應用[J]. 中華婦產科雜志, 1997, 32(5): 299-301.
6.	Luke B, Minogue J, Witte FR, et al. The ideal twin pregnancy: patterns of weight gain, disordancy and length of gestation [J].Am J Obstct Ggnecol, 1993, 169(3): 588-597.
7.	Ballabh P, Kumari J, Alkouatly HB, et al. Neonatal outcome of triplet versus twin and singleton pregnancies: amatched case control study[J]. Eur J Obstet Gynecol Reprod Biol, 2003, 107(1): 28-36.
8.	Lantz ME, Chez RA, aodriguez A, et al. Maternal weight gain patterns and birth weight outcome in twin gestation[J]. Obstet Gynecol, 1996, 87(4): 551-556.
9.	Chavez MR, Ananth CV, Smulian JC, et al. Fetal transcerebellar diameter measurement with particular emphasis in the third trimester: a reliable predictor of gestational age[J]. Am J Obstet Gynecol, 2004, 191(3): 979-984.
10.	Goldstein I, Reece EA, Pilu G, et al. Cerebellar measurements with ultrasonography in the evaluation of fetal growth and development [J]. Am J Obstet Gynecol, 1987, 156(5): 1065-1069.
11.	Chavez MR. Ananth CV. Kaminsky LM, et al. Fetal transcerebellar diameter measurement for prediction of gestational age in twins[J]. Am J Obstet Gynecol, 2006, 195(6): 1596-1600.
12.	蔡丹蕾, 謝紅寧, 李麗娟, 等. 三維超聲容積測量功能監測胎兒小腦發育[J]. 現代臨床醫學生物工程學雜志, 2006, 12(5): 393-395.
13.	徐輝雄, 徐作峰, 呂明德, 等. 三維超聲容積自動測量技術的準確性及重復性研究[J]. 中國超聲醫學雜志, 2003, 19(3): 232-236.

1. 　劉蓉, 譚金秀, 陳其能, 等. B超監測雙胎與單胎中晚期妊娠胎兒生長發育的比較[J]. 中國婦幼保健, 2007, 22(18): 2538-2539.
2. 　譚金秀. B超測量小腦橫徑監護胎兒生長發育[J]. 湖南醫學, 1993, 10(5): 262-263.
3. 　童放, 胡建群, 夏澤, 等. 三維超聲體積自動測量技術測量胎兒小腦體積及與孕齡的相關性研究[J]. 南京醫科大學學報（自然科學版）, 2008, 28(1): 94-96.
4. 　陳安珍. 雙胎妊娠胎兒發育及適宜分娩孕周的臨床研究[J]. 中國實用醫藥, 2008, 3(27): 1-2.
5. 　司徒夏印, 黃醒華. 單項超聲測量指標預測胎兒體重的臨床應用[J]. 中華婦產科雜志, 1997, 32(5): 299-301.
6. 　Luke B, Minogue J, Witte FR, et al. The ideal twin pregnancy: patterns of weight gain, disordancy and length of gestation [J].Am J Obstct Ggnecol, 1993, 169(3): 588-597.
7. 　Ballabh P, Kumari J, Alkouatly HB, et al. Neonatal outcome of triplet versus twin and singleton pregnancies: amatched case control study[J]. Eur J Obstet Gynecol Reprod Biol, 2003, 107(1): 28-36.
8. 　Lantz ME, Chez RA, aodriguez A, et al. Maternal weight gain patterns and birth weight outcome in twin gestation[J]. Obstet Gynecol, 1996, 87(4): 551-556.
9. 　Chavez MR, Ananth CV, Smulian JC, et al. Fetal transcerebellar diameter measurement with particular emphasis in the third trimester: a reliable predictor of gestational age[J]. Am J Obstet Gynecol, 2004, 191(3): 979-984.
10. 　Goldstein I, Reece EA, Pilu G, et al. Cerebellar measurements with ultrasonography in the evaluation of fetal growth and development [J]. Am J Obstet Gynecol, 1987, 156(5): 1065-1069.
11. 　Chavez MR. Ananth CV. Kaminsky LM, et al. Fetal transcerebellar diameter measurement for prediction of gestational age in twins[J]. Am J Obstet Gynecol, 2006, 195(6): 1596-1600.
12. 　蔡丹蕾, 謝紅寧, 李麗娟, 等. 三維超聲容積測量功能監測胎兒小腦發育[J]. 現代臨床醫學生物工程學雜志, 2006, 12(5): 393-395.
13. 　徐輝雄, 徐作峰, 呂明德, 等. 三維超聲容積自動測量技術的準確性及重復性研究[J]. 中國超聲醫學雜志, 2003, 19(3): 232-236.

《華西醫學》

超聲測量晚孕期正常雙胎生長參數的初步分析

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《華西醫學》

超聲測量晚孕期正常雙胎生長參數的初步分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

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