Clinical analysis of fetal isolated short femur in the second trimester
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摘要:
目的研究怀孕中期胎儿孤立型股骨短与妊娠结局的关系。 方法收集从2013年6月~2014年6月来我院行超声检查的孕中期（16~27周）孕妇247例。根据测量胎儿股骨长度的结果，分为正常股骨长度组和股骨短组，比较两组的临床特点与妊娠结局。 结果232例（93.9%）胎儿股骨长度正常，15例（6.1%）存在孤立型股骨短。股骨长度正常组孕妇的身高、妊娠前体质量以及分娩体质量均高于胎儿股骨短组，差异有统计学意义（P<0..05）。胎儿股骨短组孕妇在孕期吸烟的概率高于胎儿股骨长度正常组，差异有统计学意义（P<0..05）。胎儿股骨短组出现小于胎龄儿、足月低出生体质量、早产的概率均高于胎儿股骨长度正常组，差异有统计学意义（P<0..05）。 结论孕中期胎儿孤立型股骨短会增加发生早产、胎儿足月低出生体质量以及小于胎龄儿的风险。 Abstract:Objective We aimed to analyze the relationship between isolated short femur in the second trimester and pregnancy outcomes. Methods We collected 247 patients with a second trimester ultrasound (16-27weeks) from July 2013 to July 2014. Based on the femur length measurement, patients were divided into the normal femur length group and the short femur group. Clinical data and pregnancy outcomes of patients were compared. Results 232（93.9%）had normal femur length, 15 （6.1%）had short femur. Mothers in the short femur group were shorter and had a lower pregnancy and delivery weight than the group with normal femur length（P<0..05）. Tobacco use during pregnancy was more frequent in the short femur group (P<0..05). Small for gestational age, low birth weight and preterm birth occurred more frequently in the short femur group (P<0..05). Conclusion Fetal isolated short femur in the second trimester increases the risk of preterm birth, low birth weight and small for gestational age. -
表 1 胎儿股骨长度正常孕妇与胎儿股骨短孕妇临床特征的比较
孕妇临床特征 股骨长度正常（232 例） 股骨短（15 例） P 年龄（岁） 29.60±4.83 28.4±3.27 0.345 孕龄（周） 22.94±3.27 21.67±3.46 0.148 孕妇身高（cm） 52.47±9.28 152.40±7.61 0.024 妊娠前体质量（kg） 67.53±10.05 46.60±7.23 0.017 分娩体质量（kg） 16 59.27±7.69 0.002 妊娠期高血压/轻度子痫前期（例） 12 1 0.973 孕期糖尿病（例） 23 1 0.802 孕期吸烟史（例） 159.20±11.40 4 0.044 计量资料用均数±标准差表示. 计数资料以例数表示. 
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表 2 胎儿股骨长度正常与胎儿股骨短妊娠结局的比较
妊娠结局 股骨长度正常（232 例） 股骨短（15 例） p 早产（例） 21 4 0.028 出生体质量（g） 3230.06±576.23 2903.80±503.50 0.033 足月低出生体质量（体质量<2500 g）（例） 18 4 0.012 小于胎龄（体质量<第10 百分位数）（例） 14 3 0.038 计量资料用均数±标准差表示. 计数资料以例数表示.
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[1] 李莉, 何冰, 罗琳, 等. 超声诊断胎儿股骨偏短的临床评估意义[J]. 西部医学, 2011, 23(7): 1336-8. http://www.cnki.com.cn/Article/CJFDTOTAL-XIBU201107064.htm [2] Todros T, Massarenti I, Gaglioti P, et al. Fetal short femur length in the second trimester and the outcome of pregnancy[J]. BJOG, 2004, 111(1): 83-5. doi: 10.1046/j.1471-0528.2003.00015.x [3] Papageorghiou AT, Fratelli N, Leslie K, et al. Outcome of fetuses with antenatally diagnosed short femur[J]. Ultrasound Obstet Gynecol, 2008, 31(5): 507-11. doi: 10.1002/(ISSN)1469-0705 [4] Weisz B, David AL, Chitty L, et al. Association of isolated short femur in the mid-trimester fetus with perinatal outcome[J]. Ultrasound Obstet Gynecol, 2008, 31(5): 512-6. doi: 10.1002/(ISSN)1469-0705 [5] Goetzinger KR, Cahill AG, Macones GA, et al. Isolated short femur length on second-trimester sonography: a marker for fetal growth restriction and other adverse perinatal outcomes[J]. J Ultrasound Med, 2012, 31(12): 1935-41. https://www.ncbi.nlm.nih.gov/pubmed/23197546/ [6] Ventura W, Huaman J, Nazario CE, et al. Perinatal outcomes after sonographic detection of isolated short femur in the second trimester [J]. J Clin Ultrasound, 2012, 40(2): 63-7. doi: 10.1002/jcu.v40.2 [7] Vermeer N, Bekker MN. Association of isolated short fetal femur with intrauterine growth restriction[J]. Prenat Diagn, 2013, 33(4): 365-70. [8] Gifford RW, August PA, Cunningham G, et al. Report of the National high blood pressure education program working group on high blood pressure in pregnancy[J]. Am J Obstet Gynecol, 2000, 183(1): S1-S22. doi: 10.1067/mob.2000.107928 [9] Zeitlin J, Ancel PY, Saurel-Cubizolles MJ, et al. The relationship between intrauterine growth restriction and preterm delivery: an empirical approach using data from a European case-control study [J]. BJOG, 2000,107: 750-8. doi: 10.1111/bjo.2000.107.issue-6 [10] Ananth CV, Getahun D, Peltier MR, et al. Recurrence of spontaneous versus medically indicated preterm birth[J]. Am J Obstet Gynecol, 2006, 195: 643-50. doi: 10.1016/j.ajog.2006.05.022 [11] Zalel Y, Lehavi O, Schiff E, et al. Shortened fetal long bones: a possible in utero manifestation of placental function[J]. Prenat Diagn,2002, 22: 553-7. doi: 10.1002/(ISSN)1097-0223 -
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