تعیین سن حا ملگی بر اساس اندازه گیری سر تا نشیمن و تطبیق با قطر متوسط و حجم ساک حاملگی

نوع مقاله : اصیل پژوهشی

نویسندگان

استادیار گروه رادیو لوژی بیمار ستان قائم

چکیده

مقدمه: تعیین سن حا ملگی و تشخیص اختلال رشد جنین بر اساس اندازه گیری پا را متر های سونوگرافیک جنین میسر میشود. بهتر ین پارا متر برای تعیین سن حاملگی در سه ماهه اول اندازه گیری سر تا نشیمن (CRL) است. این مطالعه با هدف بررسی ار تباط اندازه سر تا نشیمن (CRL) و سن جنین در گروهی از زنان باردار ایرانی که پریود منظم و مشخصی داشتند محاسبه و مقا یسه آن با جدولهای موجود انجام شده است .بعلاوه ارتباط آن با حجم و قطر متوسط ساک حا ملگی (MSD) نیز مشخص شده است. روش کار: این مطالعه توصیفی از سال 83-1379 در بیمارستان سینا مشهد انجام شده است. در 417 حا ملگی یک قلو که زما ن اولین روز آخرین عادت آنها (LMP) مشخص و دوره پریود منظمی داشتند و برای سونوگرافی اندازه های سر تا نشیمن (CRL)، حجم و قطر متوسط ساک حاملگی محا سبه و نتیجه در برنامه آماری SPSS برای ویندوز ثبت شدند. جدولها و مطا لعات آماری از داده های فوق برای حا ملگی های که اندازهCRL بین 6 تا 60 میلیمتر داشتند و عوا رض حاملگی مشخصی نداشتند بدست آ مد. نتایج: بیشتر ین ار تباط بین CRL وسن حا ملگی مشا هده شد.(0001/00< p و935/0 R= ) و95% موارد بین86/4 ± روز بو دند . منا سبتر ین معادله رگرسیون برای محاسبه سن جنین بصورت زیر بدست آ مد :
 
(CRL) 080/0 –(CRL)610)² /1 +822/5 = سن حا ملگی بر اساس هفته
 
جدولی بر اساس یا فته های بدست آمده برای CRL تهیه شد که با جدول رابینسون و هادلاک و جدول مقایسه شدند. ارتباط خطیمفهوم داری بین قطر متوسط ساک حا ملگی MSD)) (0001/0 p< 886/0 = R) و حجم سا ک حاملگی. (0001/0 p< 814/0 = R) وجود داشت.
 
نتیجه گیری: تفاوت مهمی در اندازه CRL و سن حا ملگی نسبت به جداول متداول اروپا ئی و امریکائی بکار رفته در دستگا های اولترا سو ند مشا هده نشد بهتر ین زمان بر ای تعیین سن جنین بر اساسCRL که کمترین انحراف معیار را داشت 8 تا 12 هفتگی بود .

کلیدواژه‌ها

عنوان مقاله [English]

Determination of Gestational Age from Crown-Rump Length and Correlation with Volume and Mean Sac Diameters

نویسندگان [English]

  • H Rezaee
  • M Baradaran Rahimi
چکیده [English]

Introduction: Sonographic measurements of fetal ultrasound parameters are the basis for
accurate determination of gestational age and detection of fetal growth abnormalities. CRL
(crown-rump length) is the best parameter for early dating of pregnancy.
The objective of this study was to determine the relationship between gestational age
and measurement of mean diameter of gestational sac, volume of sac, and crown-rump
length in a group of pregnant women who had regular cycles and certain dates.
Materials and Methods: This descriptive study was done in Sina Hospital in 2000-
2004. Measurements of gestational sac diameter, volume, and crown-rump length(CRL)
were collected from 417 normal singleton fetuses. Charts and predictive equations were
constructed from data obtained from pregnancies in which the CRL was between 6 and
60 mm and for which the outcome was normal.
Results: CRL maintained the highest correlation with gestational age (r = 0.935, p less
than 0.0001). The standard error of estimates using CRL was significantly lower than
that using mean gestational sac or volume of the sac. The 95% reference interval was,
±4.86 days for CRL, The best fit regression equation was the quadratic model.
Age (week) = 5.822 + 1.610 CRL(cm) - 0.080(CRL) ²(cm) . A chart for CRL derived
from the regression equation are presented and compared with those obtained by
Robinson & Fleming and Hadlock.
Linear relationships were found between the mean gestational sac diameters (MDS) and
gestational age (r = 0.886, p less than 0.0001), and volume of gestational sac (r = 0.814,
p less than 0.0001).
Conclusion: There were no significant differences between the Iranian and
European parameters for the CRL and mean gestational sac curves. Crown-rump
length (CRL) between 6 and 12 weeks is the most accurate parameter for firsttrimester
dating. 

کلیدواژه‌ها [English]

  • CRL (crown-rump length)
  • LMP (last menstrual period)
  • MSD (mean gestational sac)
  • Regression equation

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مجله زنان، مامایی و نازایی ایران
دوره 9، شماره 2 - شماره پیاپی 2
پاییز و زمستان 1385
مهر 1385
صفحه 53-64

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