• 四川大學(xué)華西第二醫(yī)院超聲科（成都，610041）;

【摘要】　目的　 擬初步建立孕28~34周的雙胎胎兒生長參數(shù)超聲測量值的正常范圍，比較晚孕期單、雙胎妊娠胎兒的宮內(nèi)生長發(fā)育模式。　方法　 對(duì)2009年5月-2010年4月超聲診斷為正常宮內(nèi)雙活胎、單活胎孕婦，采用超聲測量胎兒相關(guān)生長發(fā)育指標(biāo)，包括雙頂徑、頭圍、腹圍、股骨長等，測量其中部分雙胎的小腦橫徑并應(yīng)用虛擬器官計(jì)算機(jī)輔助分析技術(shù)測量其小腦容積，比較晚孕期單、雙胎胎兒生長發(fā)育的差異。　結(jié)果　 ①自妊娠30周以后，雙胎胎兒的雙頂徑發(fā)育速度比單胎胎兒延緩，單、雙胎胎兒平均每周增長分別約2.3、1.7 mm；②自妊娠32周以后， 雙胎胎兒的頭圍的發(fā)育速度比單胎胎兒延緩，單、雙胎胎兒平均每周增長分別約6.7、5.8 mm；③自妊娠30周以后， 雙胎胎兒的腹圍的發(fā)育速度比單胎胎兒延緩，單、雙胎胎兒平均每周增長分別約6.9、5.3 mm；④雙胎胎兒股骨長從孕28~34周發(fā)育速度均較單胎胎兒緩慢，單、雙胎胎兒平均每周增長分別約2.0、1.7 mm；⑤多元分析孕28~34周的雙胎胎兒雙頂徑、頭圍、腹圍和股骨長，相對(duì)于單胎胎兒而言，自28周起，雙胎妊娠胎兒的生長發(fā)育較延緩；⑥自孕28~34周，雙胎胎兒小腦橫徑、小腦容積與單胎胎兒無明顯差異。　結(jié)論　 雙胎妊娠胎兒與單胎妊娠胎兒在晚孕期有著不同的生長發(fā)育規(guī)律。
【Abstract】　Objective　 To initially establish the growth parameters of normal twin pregnancy in 28-34 gestational ages according to the ultrasound measurement, and to compare the intrauterine growth patterns between the singleton and twin pregnancy.　Methods　 The relevant index of the twin pregnancy, including the biparietal diameter (BPD), femur length, head circumference (HC), abdominal circumference (AC), were measured. The transverse cerebellar diameter (TCD) was measured and the virtural organ computer-aided analysis was used to detect the fetal cerebellar volume (FCV). The intrauterine growth patterns between the singleton and twin pregnancy was compared.　Results　 After the gestational age of 30 weeks, the mean values of BPD of the twins pregnancies (1.7 mm) were lower than those of the singleton pregnancies (2.3 mm). After the gestational age of 32 weeks, the mean value of HC of the twins pregnancies (5.8 mm) was lower than that of the singleton pregnancies (6.7 mm). After the gestational age of 30 weeks, the mean values of AC of the twins pregnancies (5.3 mm) were lower than those of the singleton pregnancies (6.9 mm). After the gestational age of 28 weeks, the mean value of FL of the twins pregnancies (1.7 mm) was lower than the singleton pregnancies (2.0 mm). After the gestational age of 28 weeks, the growth of twin pregnancy fetuses is more slowly. After the gestational age of 28-34 weeks, the differences in mean values of TCD and FCV between the twin pregnancy and singleton pregnancy was not significant.　Conclusion　 The twin pregnancy and singleton pregnancy have different growth patterns in the third trimester pregnancy.

引用本文： 王晶,楊太珠. 超聲測量晚孕期正常雙胎生長參數(shù)的初步分析. 華西醫(yī)學(xué), 2011, 26(10): 1521-1524. doi: 復(fù)制

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8. 　Lantz ME, Chez RA, aodriguez A, et al. Maternal weight gain patterns and birth weight outcome in twin gestation[J]. Obstet Gynecol, 1996, 87(4): 551-556.
9. 　Chavez MR, Ananth CV, Smulian JC, et al. Fetal transcerebellar diameter measurement with particular emphasis in the third trimester: a reliable predictor of gestational age[J]. Am J Obstet Gynecol, 2004, 191(3): 979-984.
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11. 　Chavez MR. Ananth CV. Kaminsky LM, et al. Fetal transcerebellar diameter measurement for prediction of gestational age in twins[J]. Am J Obstet Gynecol, 2006, 195(6): 1596-1600.
12. 　蔡丹蕾, 謝紅寧, 李麗娟, 等. 三維超聲容積測量功能監(jiān)測胎兒小腦發(fā)育[J]. 現(xiàn)代臨床醫(yī)學(xué)生物工程學(xué)雜志, 2006, 12(5): 393-395.
13. 　徐輝雄, 徐作峰, 呂明德, 等. 三維超聲容積自動(dòng)測量技術(shù)的準(zhǔn)確性及重復(fù)性研究[J]. 中國超聲醫(yī)學(xué)雜志, 2003, 19(3): 232-236.
  1. 1. 　劉蓉, 譚金秀, 陳其能, 等. B超監(jiān)測雙胎與單胎中晚期妊娠胎兒生長發(fā)育的比較[J]. 中國婦幼保健, 2007, 22(18): 2538-2539.
  2. 2. 　譚金秀. B超測量小腦橫徑監(jiān)護(hù)胎兒生長發(fā)育[J]. 湖南醫(yī)學(xué), 1993, 10(5): 262-263.
  3. 3. 　童放, 胡建群, 夏澤, 等. 三維超聲體積自動(dòng)測量技術(shù)測量胎兒小腦體積及與孕齡的相關(guān)性研究[J]. 南京醫(yī)科大學(xué)學(xué)報(bào)（自然科學(xué)版）, 2008, 28(1): 94-96.
  4. 4. 　陳安珍. 雙胎妊娠胎兒發(fā)育及適宜分娩孕周的臨床研究[J]. 中國實(shí)用醫(yī)藥, 2008, 3(27): 1-2.
  5. 5. 　司徒夏印, 黃醒華. 單項(xiàng)超聲測量指標(biāo)預(yù)測胎兒體重的臨床應(yīng)用[J]. 中華婦產(chǎn)科雜志, 1997, 32(5): 299-301.
  6. 6. 　Luke B, Minogue J, Witte FR, et al. The ideal twin pregnancy: patterns of weight gain, disordancy and length of gestation [J].Am J Obstct Ggnecol, 1993, 169(3): 588-597.
  7. 7. 　Ballabh P, Kumari J, Alkouatly HB, et al. Neonatal outcome of triplet versus twin and singleton pregnancies: amatched case control study[J]. Eur J Obstet Gynecol Reprod Biol, 2003, 107(1): 28-36.
  8. 8. 　Lantz ME, Chez RA, aodriguez A, et al. Maternal weight gain patterns and birth weight outcome in twin gestation[J]. Obstet Gynecol, 1996, 87(4): 551-556.
  9. 9. 　Chavez MR, Ananth CV, Smulian JC, et al. Fetal transcerebellar diameter measurement with particular emphasis in the third trimester: a reliable predictor of gestational age[J]. Am J Obstet Gynecol, 2004, 191(3): 979-984.
  10. 10. 　Goldstein I, Reece EA, Pilu G, et al. Cerebellar measurements with ultrasonography in the evaluation of fetal growth and development [J]. Am J Obstet Gynecol, 1987, 156(5): 1065-1069.
  11. 11. 　Chavez MR. Ananth CV. Kaminsky LM, et al. Fetal transcerebellar diameter measurement for prediction of gestational age in twins[J]. Am J Obstet Gynecol, 2006, 195(6): 1596-1600.
  12. 12. 　蔡丹蕾, 謝紅寧, 李麗娟, 等. 三維超聲容積測量功能監(jiān)測胎兒小腦發(fā)育[J]. 現(xiàn)代臨床醫(yī)學(xué)生物工程學(xué)雜志, 2006, 12(5): 393-395.
  13. 13. 　徐輝雄, 徐作峰, 呂明德, 等. 三維超聲容積自動(dòng)測量技術(shù)的準(zhǔn)確性及重復(fù)性研究[J]. 中國超聲醫(yī)學(xué)雜志, 2003, 19(3): 232-236.