【摘要】 目的评估孕中期超声检查对选择性胎儿生长受限(sFGR)的早期诊断价值。方法选择2019年9月—2020年12月就诊于青岛妇女儿童医院的单绒毛膜性(MC)双胎妊娠孕妇,收集孕妇的一般人口学特征、孕产史、妊娠结局等临床资料。所有孕妇均在妊娠16～24周时对sFGR进行超声诊断。采用受试者工作特征曲线(ROC)及其曲线下面积(AUC)评估孕中期超声检查对sFGR的早期诊断价值。结果在93例MC双胎妊娠孕妇中,发生sFGR者34例,平均年龄为31.04岁,孕前平均BMI为22.55 kg/m~2。孕中期超声诊断sFGR的灵敏度、特异度分别为67.65%、79.66%,阳性预测值与阴性预测值分别为65.71%、81.03%。ROC曲线分析显示,采用腹围不一致与估计胎儿体质量不一致联合指标对sFGR的诊断价值最大,AUC为0.78(95%CI=0.68～0.89)。结论孕中期超声检查对sFGR的早期诊断有较高的价值,其中腹围不一致与估计胎儿体质量不一致联合指标为最佳诊断指标。更多还原

【Abstract】 Objective To investigate the value of ultrasound examination in the second trimester in the early diagnosis of selective fetal growth restriction(sFGR). Methods The women with monochorionic(MC) twin pregnancy who attended Qing-dao Women and Children’s Hospital, Qingdao University, from September 2019 to December 2020 were enrolled, and related cli-nical data were collected, including demographic features, pregnancy and childbirth history, and pregnancy outcome. Ultrasound examination was performed for all women at 16-24 weeks of pregnancy. The receiver operating characteristic(ROC) curve and the area under the ROC curve(AUC) were used to evaluate the value of ultrasound examination in the second trimester in the early diagnosis of sFGR. Results Among the 93 women with MC twin pregnancy, 34 were found to have sFGR, with a mean age of 31.04 years and a mean body mass index of 22.55 kg/m~2 before pregnancy. Ultrasound examination in the second trimester had a sensitivity of 67.65% and a specificity of 79.66% in the diagnosis of sFGR, with a positive predictive value of 65.71% and a negative predictive value of 81.03%. The ROC curve analysis showed that abdominal circumference discordance combined with estimated fetal weight discordance had the highest value in the diagnosis of sFGR, with an AUC of 0.78(95%CI=0.68-0.89). Conclusion Ultrasound examination in the second trimester has a relatively high value in the early diagnosis of sFGR, and abdo-minal circumference discordance combined with estimated fetal weight discordance has the best diagnostic value.更多还原