جستجوی ارتباط بین سطح مقطع بندناف با وزن جنین در سونوگرافی

نوع مقاله: اصیل پژوهشی

نویسندگان

1 استادیار گروه رادیولوژی، دانشکده پزشکی، دانشگاه آزاد اسلامی واحد مشهد، مشهد، ایران.

2 پزشک عمومی، دانشکده پزشکی، دانشگاه آزاد اسلامی واحد مشهد، مشهد، ایران.

چکیده

مقدمه: وزن غیر طبیعی جنین در زمان تولد با افزایش خطر عوارض نوزادی حوالی زایمان همراه است. تکنیک های متفاوتی برای ارزیابی وزن جنین به کار می رود که مدرن ترین آن استفاده از اولتراسونوگرافی است. اما این روش هم در  جنین های ماکروزوم می تواند خطای وزنی بالغ بر صدها گرم ایجاد کند. لذا مطالعه حاضر با هدف بررسی رابطه بین سطح مقطع بندناف و وزن جنین از طریق سونوگرافی انجام شد.
روش کار: این مطالعه توصیفی- تحلیلی و مقطعی در سال1393 بر روی 200 زن باردار مراجعه کننده به بخش سونوگرافی بیمارستان های 22 بهمن و آریا مشهد انجام شد. وزن جنین بر اساس شاخص های بیومتریک توسط سونوگرافی تخمین زده شد و سطح مقطع بندناف برای تمام زنان باردار اندازه گیری شد. تجزیه و تحلیل داده ها با استفاده از نرم افزار آماری SPSS (نسخه 20)، Statistica-10 انجام شد.جهت بررسی رابطه بین سطح مقطع بند ناف و وزن جنین از رگرسیون خطی و ضریب همبستگی پیرسون استفاده گردید. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته‌ها: 107 نفر (5/53%) از زنان باردار مورد بررسی، در سه ماهه دوم بارداری قرار داشتند. 126 جنین (63%) در صدک وزنی محدوده 50-30 قرار داشتند. سطح مقطع بندناف در 50 جنین(25%) زیر 50 میلی متر مربع و در 48 جنین (24%) بین 200-150 میلی متر مربع بود. بین سطح مقطع بندناف با وزن جنین و با صدک وزن در هر دو جنس مذکر و مؤنث در سه ماهه دوم بارداری ارتباط مستقیم و معناداری وجود داشت (0001/0>p)، اما این ارتباط در سه ماهه سوم بارداری معنادار نبود (05/0<p).
نتیجه‌گیری: بین سطح مقطع بندناف و وزن جنین در سه ماهه دوم بارداری ارتباط معناداری وجود دارد، لذا شاخص فوق در کنار شاخص های بیومتریک جهت تخمین دقیق تر وزن جنین سودمند می باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Assessment of relationship between cross sectional area of umbilical cord and fetal weight in Ultrasonography

نویسندگان [English]

  • Narges Afzali 1
  • Mahsa Noferesti 2
1 Assistant Professor, Department of Radiology, School of Medicine, Islamic Azad University, Mashhad Branch, Mashhad, Iran
2 General Physician, School of Medicine, Islamic Azad University, Mashhad, Mashhad Branch, Iran.
چکیده [English]

Introduction: Abnormal fetal weight at birth is associated with increased risk of perinatal neonatal outcomes. Different techniques are used to assess fetal weight that the most modern is the use of ultrasonography. But this method also can cause weighing error of hundreds of grams in macrosomic fetuses. Therefore, this study was performed with aim to assess the relationship between the cross-sectional area of the umbilical cord and fetal weight through sonography.
Methods: This descriptive-analytical and cross-sectional study was performed on 200 pregnant women with gestational age of 17-40 weeks referred to Mashhad Aria and 22 Bahman Hospitals from September 2013 to 2014. The fetal weight was estimated based on biometric indexes by sonography and cross-sectional area of umbilical cord were measured for all pregnant women. Data were analyzed by SPSS statistical software (version 20), and Statistica-10, linear regression and Pearson’s correlation coefficient. PResults: 107 pregnant women (53.5%) were in second trimester of pregnancy. 126 cases of fetuses (63%) were in 30-50 weight percentile. The cross-sectional area of umbilical cord in 50 cases (25%) was 2 and in 48 (24%) was 150-200 mm2. There was a significant direct relationship between cross-sectional area of umbilical cord with fetal weight and weight percentile in both female and male during second trimester of pregnancy (P<0.0001), but this relationship was not significant in third trimester (P>0.05).
Conclusion: There was a significant relationship between cross-sectional area of umbilical cord with fetal weight in second trimester of pregnancy, so, it can be useful along with biometric indexes to more accurate estimation of fetal weight.

کلیدواژه‌ها [English]

  • Cross-Sectional area
  • Fetal weight
  • Ultrasonography
  • Umbilical cord
  1. Donna LW. The High-Risk newborn and family. In: Hockenberry MJ, Wilson D, editors. Wong’s nursing care of infants and children. 7th ed. St Louis: Mosby; 2003. P. 249.
  2. Pang MW, Leung TN, Lau TK. A validation study of ultrasonic fetal weight estimation models for Hong Kong Chinese singleton pregnancies. Hong Kong Med J 2004; 10(6):384-8.
  3. Nesbitt TS, Gillbert WM, Herrchen B. Shoulder dystocia and associated risk factors with macrosomic infants born in California. Am J Obstet Gynecol 1998; 179 (2):476-80.
  4. Wilcox AJ, Skjaerven R. Birth weight and perinatal mortality: The effect of gestational age. Am J Public Health 1992; 82(3):378-82.
  5. Spong CY. Diseases and injuries of the fetus and newborn. In:Cunningham FG, Leveno KJ, Bloom SL, editors. William’s Obstetrics. 21st ed. NewYork: McGraw Hill Medical Publishing Division; 2001. P. 744-6.
  6. Najafian M, Cheraghi M. Occurrence of fetal macrosomia rate and its maternal and neonatal complicatins: A 5-Year cohort study. ISRN Obstet Gynecol 2012; 2012:353791.
  7. Nahum GG, Stanislaw H. Hemoglobin, altitude and birth weight; does maternal anemia during pregnancy influence fetal growth? J Reprod Med 2004; 49(4):297-305.
  8. Esmaili H, Farhat AS, MirzaiNajmabadi K, Dadgar S, Karimi A , KhojastehGelayami M. The relationship between maternal body mass index at the beginning of pregnancy and infants' birth weight and pregnancy outcomes. Iran J Obstet Gynecol Infertil 2014; 85(16):1-10. (Persian).
  9. Zhang J, Bowes WA Jr. Birth weight for gestational-age patterns by race, sex and parity in the United States population. Obstet Gynecol 1995; 86(2):200-8.
  10. Yazani S, Bouzari Z, Allah Nazarai M, Bijani A. Comparison of fetal weight estimation with clinical, ultrasonographic methods, and combined formula of ultrasonography and maternal weight. Iran J Obstet Gynecol Infertil 2014; 106(17):1-7. (Persian).
  11. Hill ML. Fetal measurements. In: Mc Gahan PJ, Goldberge BB, editors. Diagnostic Ultrasound. 2nd ed. New York: Informa Health Care USA Inc; 2008. P. 1078-84.
  12. Pinette MG, Pan Y, Pinette SG, Blackstone J, Garrett J, Cartin A. Estimation of fetal weight: mean value from multiple formulas. J Ultrasound Med 1999; 18(12):813-7.
  13. Raio L, Ghezzi F, Di Naro E, Gomez R, Franchi M, Mazor M, et al. Sonographic measurement of the umbilical cord and fetal anthropometric parameters. Eur J Obstet Gynecol Reprod Biol 1999; 83(2):131-5.
  14. Ghezzi F, Raio L, Di Naro E, Franchi M, Balestreri D, D’Addario V. Nomogram of Wharton’s jelly as depicted in the sonographic cross section of the umbilical cord. Ultrasound Obstet Gynecol 2001; 18(2):121-5.
  15. Weissman A, Jakobi P, Bronshtein M, Goldstein I. Sonographic measurements of the umbilical cord and vessels during normal pregnancies. J Ultrasound Med 1994; 13(1):11-14.
  16. Togni FA, Araújo Junior E, Vasques FA, Moron AF, Torloni MR, Nardozza LM. The cross-sectional area of umbilical cord components in normal pregnancy. Int J Gynaecol Obstet 2007; 96(3):156-61.
  17. Togni FA, Araujo Junior E, Moron AF, Vasques FA, Torloni MR, Nardozza LM, et al. Reference intervals for the cross sectional area of the umbilical cord during gestation. J Perinatal Med 2007; 35(2):130-4.
  18. Binbir B, Yaniel AO, Ergenoglu AM, Kazandi M, Akercan F, Sagol S. The role of umbilical cord thickness and HbA1c levels for the prediction of macrosomia in patient with gestational diabetes mellitus. Arch Gynecol Obstet 2012; 285(3):635-9.
  19. Barbieri C, Cecatti JG, Surita FG, Costa ML, Marussi EF, Costa JV. Area of Wharton's jelly as an estimate of the thickness of the umbilical cord and its relationship with estimated fetal weight. Reprod Health 2011; 8:32.
  20. Coromi A, Ghezzi F, Di Naro E, Siesto G, Bergamini V, Raio L. Large cross-sectional area of the umbilical cord as a predictor of fetal macrosomia. Ultrasound Obstet Gynecol 2007; 30(6):861-6.
  21. Tahmasebi M, Alighanbari R. Evaluation of umbilical cord thickness, cross-sectional area, and coiling index as predictors of pregnancy outcome. Indian J Radiol Imaging 2011; 21(3):195-8.