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Obstet Gynecol:超声过度诊断“大于胎龄儿”会增加剖宫产风险

2015-10-14 Mechront 译 MedSci原创

糖尿病孕妇孕妇最常见的是羊水过多与胎儿过大。对于胎儿的评估,因为其在孕妇肚子里,只有通过B超看到胎儿情况,根据二维条件下的检测指标,对胎儿生长发育进行评估。而超声对胎儿体重的评估会影响到孕妇分娩方式的选择。Scifres CM等人进行了一项研究,评估对于妊娠期糖尿病孕妇,对其胎儿超声诊断为“大于胎龄儿(LGA)”的准确性,以及因该诊断而导致接下来的剖宫产风险。研究者对903名GDM孕妇进行了一项回

糖尿病孕妇的羊水过多与胎儿过大是很常见的。对于胎儿的评估,因为其在孕妇肚子里,只有通过B超看到胎儿情况,根据二维条件下的检测指标,对胎儿生长发育进行评估。而超声对胎儿体重的评估会影响到孕妇分娩方式的选择。

Scifres CM等人进行了一项研究,评估对于妊娠期糖尿病孕妇,对其胎儿超声诊断为“大于胎龄儿(LGA)”的准确性,以及因该诊断而导致接下来的剖宫产风险。

研究者对903名GDM孕妇进行了一项回顾性队列研究,所有研究对象均在孕36周后分娩,并且在分娩的31天内进行了超声检查。研究者根据超声检查是否对胎儿诊断为LGA,将研究对象分成了两组,并对两组间结果进行比较。

基于超声检查的评估,研究者发现了248可疑LGA孕妇,以及655名非LGA孕妇。在LGA组,分娩时有56/248(22.6%)名新生儿为LGA;在非LGA组,分娩后有18/655(2.8%)名新生儿为LGA。研究者校正了相关混杂因素后发现,超声诊断为“LGA”会增加剖宫产风险(aOR 3.13, 95% CI 2.10-4.67,P<.001)。根据新生儿出生体重进行分层分析后发现,不管出生体重是在2500-3499g范围,还是3500-4500g之间,超声检查下“LGA”的诊断均会增加剖宫产风险:2500-3499g(OR 2.82, 95% CI 1.62-4.84, P<.001); 3500-4500g(OR 3.47, 95% CI 2.06-5.88, P<.001)。

研究结果表明,对于妊娠期糖尿病(GDM)孕妇,超声会过度诊断大于胎龄儿(LGA)、高估LGA的发生率。并且超声诊断“LGA”会增加孕妇剖宫产风险,并且不管新生儿出生体重如何,该增加的风险依旧存在。

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    2016-08-30 李东泽

    这篇咨询不错哦,值得学习,对于临床工作和科研思路都很有帮助。

    0

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    2016-04-07 王明星

    写的很客观!赞一个!

    0

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    2016-06-12 yhy100200
  7. [GetPortalCommentsPageByObjectIdResponse(id=2043860, encodeId=1d7a2043860d8, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Sun Feb 28 06:19:00 CST 2016, time=2016-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=107757, encodeId=13b210e75798, content=这篇咨询不错哦,值得学习,对于临床工作和科研思路都很有帮助。, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Tue Aug 30 23:02:00 CST 2016, time=2016-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1740307, encodeId=7f001e4030719, content=<a href='/topic/show?id=f9f383688d0' target=_blank style='color:#2F92EE;'>#胎龄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83688, encryptionId=f9f383688d0, topicName=胎龄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f53c34728820, createdName=ms8538335253054589, createdTime=Sun Sep 25 22:19:00 CST 2016, time=2016-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1809488, encodeId=553e1809488cf, content=<a href='/topic/show?id=c9f18368966' target=_blank style='color:#2F92EE;'>#胎龄儿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83689, encryptionId=c9f18368966, topicName=胎龄儿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=82ba2500166, createdName=ms1467340776200723, createdTime=Thu Jun 02 00:19:00 CST 2016, time=2016-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76161, encodeId=5eeee616160, content=写的很客观!赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0c881700851, createdName=王明星, createdTime=Thu Apr 07 06:11:00 CST 2016, time=2016-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2011196, encodeId=f36f20111968f, content=<a href='/topic/show?id=840d1e300e5' target=_blank style='color:#2F92EE;'>#TET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17300, encryptionId=840d1e300e5, topicName=TET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cc52251, createdName=yhy100200, createdTime=Sun Jun 12 07:19:00 CST 2016, time=2016-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39384, encodeId=0629393842b, content=谢谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 23:03:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39385, encodeId=9d393938580, content=赞一个~, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 23:03:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39386, encodeId=146b393866d, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 23:03:00 CST 2015, time=2015-10-18, status=1, ipAttribution=)]
    2015-10-18 sunlong28

    谢谢分享~

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2043860, encodeId=1d7a2043860d8, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Sun Feb 28 06:19:00 CST 2016, time=2016-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=107757, encodeId=13b210e75798, content=这篇咨询不错哦,值得学习,对于临床工作和科研思路都很有帮助。, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Tue Aug 30 23:02:00 CST 2016, time=2016-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1740307, encodeId=7f001e4030719, content=<a href='/topic/show?id=f9f383688d0' target=_blank style='color:#2F92EE;'>#胎龄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83688, encryptionId=f9f383688d0, topicName=胎龄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f53c34728820, createdName=ms8538335253054589, createdTime=Sun Sep 25 22:19:00 CST 2016, time=2016-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1809488, encodeId=553e1809488cf, content=<a href='/topic/show?id=c9f18368966' target=_blank style='color:#2F92EE;'>#胎龄儿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83689, encryptionId=c9f18368966, topicName=胎龄儿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=82ba2500166, createdName=ms1467340776200723, createdTime=Thu Jun 02 00:19:00 CST 2016, time=2016-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76161, encodeId=5eeee616160, content=写的很客观!赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0c881700851, createdName=王明星, createdTime=Thu Apr 07 06:11:00 CST 2016, time=2016-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2011196, encodeId=f36f20111968f, content=<a href='/topic/show?id=840d1e300e5' target=_blank style='color:#2F92EE;'>#TET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17300, encryptionId=840d1e300e5, topicName=TET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cc52251, createdName=yhy100200, createdTime=Sun Jun 12 07:19:00 CST 2016, time=2016-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39384, encodeId=0629393842b, content=谢谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 23:03:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39385, encodeId=9d393938580, content=赞一个~, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 23:03:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39386, encodeId=146b393866d, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 23:03:00 CST 2015, time=2015-10-18, status=1, ipAttribution=)]
    2015-10-18 sunlong28

    赞一个~

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2043860, encodeId=1d7a2043860d8, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Sun Feb 28 06:19:00 CST 2016, time=2016-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=107757, encodeId=13b210e75798, content=这篇咨询不错哦,值得学习,对于临床工作和科研思路都很有帮助。, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Tue Aug 30 23:02:00 CST 2016, time=2016-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1740307, encodeId=7f001e4030719, content=<a href='/topic/show?id=f9f383688d0' target=_blank style='color:#2F92EE;'>#胎龄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83688, encryptionId=f9f383688d0, topicName=胎龄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f53c34728820, createdName=ms8538335253054589, createdTime=Sun Sep 25 22:19:00 CST 2016, time=2016-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1809488, encodeId=553e1809488cf, content=<a href='/topic/show?id=c9f18368966' target=_blank style='color:#2F92EE;'>#胎龄儿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83689, encryptionId=c9f18368966, topicName=胎龄儿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=82ba2500166, createdName=ms1467340776200723, createdTime=Thu Jun 02 00:19:00 CST 2016, time=2016-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76161, encodeId=5eeee616160, content=写的很客观!赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0c881700851, createdName=王明星, createdTime=Thu Apr 07 06:11:00 CST 2016, time=2016-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2011196, encodeId=f36f20111968f, content=<a href='/topic/show?id=840d1e300e5' target=_blank style='color:#2F92EE;'>#TET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17300, encryptionId=840d1e300e5, topicName=TET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cc52251, createdName=yhy100200, createdTime=Sun Jun 12 07:19:00 CST 2016, time=2016-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39384, encodeId=0629393842b, content=谢谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 23:03:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39385, encodeId=9d393938580, content=赞一个~, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 23:03:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39386, encodeId=146b393866d, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 23:03:00 CST 2015, time=2015-10-18, status=1, ipAttribution=)]
    2015-10-18 sunlong28

    为了积分我也是拼了~

    0

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