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LIMITATIONS IN PREDICTION OF GESTATIONAL AGE AND BIRTH-WEIGHT BY ULTRASONOGRAPHIC METHODS

JOURNAL OF CLINICAL ULTRASOUND 1978年第4期6卷 233-238页

作者： GONZALEZ, AC DALE, E BYERS, RH Departments of Radiology Gynecology Obstetrics and Computer Science Emory University School of Medicine Grady Memorial Hospital Atlanta Georgia Technical Assistance

The index of predictability of estimated gestational age (EGA) and birth weight (BW) from biparietal diameter (BPD) was tested in 1333 normal pregnancies; 96% of the patients were black. The correlation BPD and actual weeks to delivery was 0.834, r2 =69.5%. Confidence limits were established and a nomogram for EGA was derived. Our nomogram and two similar ones were compared. The overall correlation between them was good, but that for specific BPD and EGA was not. In addition, our BPD values were smaller for corresponding gestational ages in other nomograms. The overall accuracy of estimated delivery date was +/- 1.6 weeks. We were not able to predict birth weight at all from a single, random BPD measurement. We have demonstrated the serious limitations that exist in the prediction of gestational age from previously established nomograms. We infer that this error is even greater when homogenous populations are so studied. We suggest that any published BPD-EGA or BPD-BW nomogram be given close, intensive statistical scrutiny, within the population studied, before it is used. When such scrutiny is not possible, serial sonographic determinations, or longitudinal use of growth charts, would be more acceptable.

关键词：生物统计学/方法出生体重胎儿/解剖学和组织学孕龄数学顶骨/胚胎学超声检查青少年成年人女(雌)性人类妊娠

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SONOGRAPHY IN OBSTETRICS

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RADIOLOGIC CLINICS OF NORTH AMERICA 1975年第3期13卷 435-455页

作者： SANDERS, RC CONRAD, MR JOHNS HOPKINS HOSP MED INSTDEPT RADIOL & RADIOL SCIBALTIMOREMD 21025

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Estimation of fetal weight in twins: a new mathematical model

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BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1999年第9期106卷 924-928页

作者： Ong, S Smith, APM Fitzmaurice, A Campbell, D Aberdeen Matern Hosp Dept Ultrasound Aberdeen AB25 2ZD Scotland Aberdeen Matern Hosp Dugald Baird Ctr Aberdeen AB25 2ZD Scotland

Objectives Evaluation of new mathematical formula (Femur 4) derived from a twin population to estimate fetal weight in twins using ultrasound. Comparison of Femur 4 is with conventional mathematical models. Design Retrospective analysis of ultrasonic measurements of 297 twin babies from 24 to 40 weeks of gestation who were born within 10 days of ultrasound examination. Setting Aberdeen Maternity Hospital. Methods With ultrasonic measurements obtained from twin babies, estimated fetal weight was calculated using the mathematical models of Campbell, Shepard and Hadlock. The calculations were repeated for the model of Femur 4. All models were compared against Femur 4. Results The coefficient of determination of the linear regression between the actual and predicted weight was highest for Femur 4 (0.852). Femur 4 had the highest proportion of babies with estimated weights within 10% of actual birthweight (71.4%). in babies who weighed between 2000 and 3000 g, Femur 4 had the least systematic and random error of -1.69 and 8.96, respectively. For babies below the 10th centile for weight, Femur 4 had comparable positive and negative predictive values of 76.0% and 92.3%, respectively. Femur 4 was equally poor at predicting growth discordancy with positive and negative predictive values of 70.0% and 86.5% only. Conclusion Femur 4 requires measurements of femur length and abdominal circumference only, hence avoiding the need to obtain difficult head measurements which is a common problem in twins. It is a good model for estimation of fetal weight in twins. However, prediction of growth discordancy remains problematic.

关键词：体重股骨/诊断显像股骨/胚胎学胎儿生长迟缓/诊断胎儿/解剖学和组织学头部/诊断显像头部/胚胎学模型理论回顾性研究敏感性与特异性双生超声检查产前女(雌)性人类妊娠

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FETAL CROWN-RUMP LENGTH AND BIPARIETAL DIAMETER IN SECOND TRIMESTER OF PREGNANCY

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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 1975年第1期122卷 9-12页

作者： BERGER, GS EDELMAN, DA KERENYI, TD UNIV N CAROLINA DEPT OBSTET & GYNECOLINT FERTIL RES PROGRAMCHAPEL HILLNC 27514 MT SINAI SCH MED CHAPEL HILLNC

This study examines the relationships between fetal size (biparietal diameter and crown-rump length) and gestational age among subjects aborted by hypertonic saline in the second trimester of pregnancy. With a confidence of 90 per cent, biparietal diameter can be used to predict gestational age within ±2 weeks, and crown-rump length can be used to predict gestational age within ±3 weeks.

关键词：流产人工身高测颅法胎儿/解剖学和组织学胎儿/生理学孕龄生长妊娠中期颅骨/胚胎学氯化钠/治疗应用女(雌)性人类妊娠

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Regional size reduction in the human corpus callosum following pre- and perinatal brain injury

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CEREBRAL CORTEX 2000年第12期10卷 1200-1210页

作者： Moses, P Courchesne, E Stiles, J Trauner, D Egaas, B Edwards, E Univ Calif San Diego Dept Cognit Sci La Jolla CA 92093 USA Childrens Hosp Res Ctr Lab Res Neurosci Autism San Diego CA 92123 USA Univ Calif San Diego Sch Med Dept Neurosci La Jolla CA 92093 USA

This morphometric study examined two aspects of corpus callosum development: pediatric cortico-callosal topography and developmental neuroplasticity subsequent to perinatal brain injury. In vivo magnetic resonance imaging was used to quantify the total midsagittal cross-sectional area and five anterioposterior subregions of the callosum in 10 children with focal lesions and 86 healthy volunteer control subjects. Nine of the ten children with early injury showed a reduction in the total area of the callosum relative to matched controls. The area of the total callosum cross-section was inversely proportional to the size of lesion. All patients displayed region-specific size reduction. This regional thinning bore a topographical relationship to the lesion sites. Reduction in anterior subregions 1, 2 and 3 was respectively associated with lesions in the anterior inferior frontal area, the middle and superior frontal region, and the precentral area. Attenuation of subregion 4 corresponded to anterior parietal lesions, and thinning of subregion 5 occurred with posterior parietal injury. This cortical-callosal pattern coincides with adult and nonhuman primate mappings. Callosal thinning despite the early onset of the lesions suggests limits to developmental neuroplasticity.

关键词：脑损伤/诊断胼胝体/病理学胎儿/解剖学和组织学磁共振成像青少年成年人儿童儿童学龄前女(雌)性人类婴儿新生男(雄)性

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IDENTIFICATION OF FETAL GROWTH-RETARDATION BY ULTRASONOGRAPHIC ESTIMATION OF TOTAL INTRA-UTERINE VOLUME

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JOURNAL OF CLINICAL ULTRASOUND 1979年第1期7卷 21-26页

作者： LEVINE, SC FILLY, RA CREASY, RK UNIV CALIF SAN FRANCISCO SCH MED DEPT RADIOL SAN FRANCISCO CA 94143 USA

Total intrauterine volume (TIUV) estimation may be useful for distinguishing normal from growth-retarded fetuses. Measurements of TIUV (179) were obtained from the ultrasonograms taken between 21-40 wk of gestation in 140 patients who delivered average birth wt babies. A mean curve for TIUV with upper and lower 2.5 and 10% tolerance limits was constructed and the TIUV''s of 16 patients with growth-retarded fetuses evaluated. Of these fetuses, 9 had birth wt below the 5th percentile for gestational age, and in each of these pregnancies the TIUV ultimately fell below the lower 2.5% tolerance limit.

关键词：出生体重身高测颅法胎儿生长迟缓/诊断胎儿/解剖学和组织学头部/解剖学和组织学羊水过多/病理学超声检查子宫/解剖学和组织学女(雌)性人类妊娠

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Blood chemistry, nutrient metabolism, and organ weights in fetal and newborn calves derived from in vitro-produced bovine embryos

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BIOLOGY OF REPRODUCTION 2000年第6期62卷 1495-1504页

作者： Sangild, PT Schmidt, M Jacobsen, H Fowden, AL Forhead, A Avery, B Greve, T Royal Vet & Agr Univ Dept Anim Sci & Anim Hlth Div Nutr DK-1870 Frederiksberg C Denmark Royal Vet & Agr Univ Dept Clin Studies Div Reprod DK-1870 Frederiksberg C Denmark Univ Cambridge Dept Physiol Cambridge CB2 3EG England

Calves born after in vitro production (IVP) of embryos often show reduced perinatal viability. The present experiment investigated a series of physiological variables in the immediate prenatal and postnatal period of IVP dairy calves. Petal IVP and control calves (each n = 7) were prepared with vascular catheters at 248 +/- 1 day gestation (term = 280 days), and blood samples were taken for five days before premature delivery by cesarean section. IVP fetuses compared with controls had significantly elevated arterial hemoglobin and oxygen content (8.41 vs. 7.52% and 5.75 vs. 3.79%, respectively) whereas lactate level was lowered (1.89 vs. 2.26 mM). The umbilical venous-arterial concentration differences in oxygen, lactate, and glucose indicated that IVP fetuses relied more on lactate and less on glucose as oxidative substrates. The fetal glucose tolerance, and the basal and adrenocorticotropin-stimulated cortisol levels were similar between the groups. In the immediate postnatal period, IVP calves showed elevated venous blood pH (7.294 vs. 7.270), hemoglobin (9.06 vs. 8.25%), oxygen contents (6.33 vs. 4.64%), KC levels (4.89 vs. 4.56 mM), and rectal temperature (38.9 vs. 37.4 degrees C), and lowered blood Na+ (139.9 vs. 141.0 mM), CI- (100.2 vs. 103.1 mM) and glucose levels (2.86 vs. 3.11 mM). There were no differences in body dimensions and organ weights, except that the fore legs and hind legs were slightly longer in the IVP group (76.1 vs. 72.4 cm and 93.4 vs. 88.8 cm, respectively). Although prenatal and neonatal IVP calves differed from control calves in a number of variables, the effects were relatively minor and provide no direct evidence for the hypothesis that IVP calves have an impaired capacity to adapt to life ex utero. In fact, several parameters indicated enhanced rather than retarded maturation of IVP calves when data from premature calves were compared with data from a group of control carves delivered at term.

关键词：动物营养生理学动物新生/解剖学和组织学动物新生/代谢动脉血流速度血糖/分析体重牛/胚胎学受精体外胎儿/解剖学和组织学胎儿/代谢胎儿/外科学引产/兽医学乳酸/血液器官测量氧/血液脐静脉静脉动物女(雌)性妊娠

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ESTIMATING AGE OF HUMAN FETUS FROM CROWN-RUMP MEASUREMENTS

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ANNALS OF HUMAN BIOLOGY 1975年第4期2卷 387-390页

作者： BAGNALL, KM JONES, PRM HARRIS, PF UNIV TECHNOL LOUGHBOROUGH DEPT HUMAN SCILOUGHBOROUGHENGLAND UNIV MANCHESTER DEPT ANATMANCHESTERENGLAND

When data from various sources were compared, it was found that estimates of foetal age based upon crown-rump measurements varied considerably. These variations are probably related to the positions in which the foetuses were measured. Tables relating foetal age to foetal length should therefore specify the precise posture in which the foetus was placed for measurement. A standard readily reproducible position is proposed for the foetus when recording its length and it is suggested that crown-rump length should be related to "conceptual" age instead of the more conventional "menstrual" age.

关键词：人体测量术/方法身高胎儿/解剖学和组织学孕龄参考值人类

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MATURATIONAL CHANGES IN FETAL GLOMERULAR-FILTRATION RATE

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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 1975年第5期122卷 601-606页

作者： ROBILLARD, JE KULVINSKAS, C SESSIONS, C BURMEISTER, L SMITH, FG UNIV IOWA DEPT PREVENT MEDIOWA CITYIA 52240 UNIV IOWA SCH MEDDEPT PEDIATIOWA CITYIA 52240

Few data are available documenting the evolution of glomerular filtration rate (GFR) during gestation. In order to investigate this aspect, 33 fetal sheep have been studied, with the use of an intrauterine fetal preparation. It appears that the actual GFR (AGFR) in milliliters per minute increased during the last third of gestation without a significant increase in CFR expressed as milliliters per minute per kilogram of fetal weight (GFR-FW) and as milliliters per minute per gram of kidney weight (GFR-KW). It is suggested that a parallel and constant increase in AGFR and in total fetal weight or kidney weight might explain the absence of variation in GFR-FW or GFR-KW during the last third of gestation.

关键词：衰老方差分析体重胎儿/解剖学和组织学胎儿/生理学孕龄肾小球滤过率肾/胚胎学器官测量妊娠动物绵羊动物女(雌)性妊娠

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Urinary tract anomalies and dysfunctional voiding: a spectrum dictated by the influence of amniotic pressure upon fetal urodynamics

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MEDICAL HYPOTHESES 2000年第1期54卷 140-145页

作者： Tanyel, FC Hacettepe Univ Inst Child Hlth Dept Pediat Surg Ankara Turkey

The etiologic basis of urinary tract anomalies and dysfunctional voiding largely remain unknown. However, the travel of urine from renal pelvis into the amniotic cavity under the pressures exerted by amniotic fluid satisfactorily explains the etiologic basis. Amniotic pressure is affected by the changes in maternal intraabdominal pressure. The intraabdominal pressure of the fetus is also dictated by the amniotic pressure. Amniotic pressure compresses the urethra throughout the length, and may increase both bladder leak point pressure and urethral resistance. Furthermore, the urine is propelled against amniotic pressure. These factors closely simulate outflow obstruction. Since the pressure within the bladder with minimal urine content reflects the intraabdominal pressure, intravesical pressure is also elevated during fetal life. Additionally, elevated intravesical pressures impair ureteral drainage. The compressive effect exerted by fetal intraabdominal pressure upon ureters, further elevate the pressure within the renal pelvis. While forwarding the urine against these pressures may result in anomalies of the urinary tract, the increased work load of the detrusor may act as a state of injury that forms the basis of dysfunctional voiding. (C) 2000 Harcourt Publishers Ltd.

关键词：胎儿/解剖学和组织学胎儿/病理生理学泌尿道/畸形泌尿道/病理生理学人类

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