胎儿生长受限的胎盘因素及其临床诊治
Placental factor and clinical diagnosis and treatment of fetal growth restriction.
胎儿生长受限又称宫内生长受限,是产科常见并发症之一,也是围产儿死亡的第2大原因。可引起多种围产不良结局,且与多种远期成年疾病相关。因此,及早进行病因学诊断, 合理监测胎儿健康状况,准确评估胎儿生长发育情况以及选择合适分娩方式,适时终止妊娠对于改善胎儿生长受限预后, 降低围产儿病率和死亡率至关重要。
Abstract:Fetal growth restriction,also known as intrauterine growth restriction, is one of the common complications of pregnancy in obstetrics. And it is also the second reason of perinatal death which has been associated with a variety of adverse perinatal outcomes and long-term complications in later life. So it is essential to make etiology diagnosis timely, monitor the fetal growth and well-being closely, and determine the optimal time for and route of delivery for the purpose of improving the outcomes and reducing perinatal morbidity and mortality of FGR fetus.
胎儿生长受限 / 宫内生长受限 / 多普勒 / 超声 / 脐动脉
fetal growth restriction / intrauterine growth restriction / Doppler / ultrasound / umbilical artery
[1] ACOG practice bulletin. Intrauterine growth restriction[J]. Int J Gynecol Obstet, 2013,121(5): 1122-1133.
[2] Royal College of Obstetricians and Gynaecologists.RCOG Green Top Guideline Number 31:The investigation and management of the small-for-gestational-age fetus[EB/OL].[2015-03-01]. http://www.guideline.gov/content.aspx?id=44347.
[3] 乔娟,漆洪波.胎儿生长受限:更新的认识[J].中华围产医学杂志,2015,18(6):418-420.
[4] Fowden AL, Ward JW, Wooding FPB, et al. Programming placental nutrient transfer capacity[J].J Physiol,2006,572:5-15.
[5] Song Z, Regnault TRH, Paige L, et al. Placental adaptations in growth restriction [J].Nutrients,2015,7:360-389.
[6] Thompson MO, Vines SK, Aquilina J, et al. Are placental lakes of any clinical significance? [J]. Placenta,2002, 23:685–690.
[7] 刘艳鸽,杨秀丽.肝素治疗胎儿生长受限27例临床研究[J].中国现代应用药学,2006,23(7):176-179.
[8] Erel CT, Dane B, Calay Z, et al. Apoptosis in the placenta of pregnancies complicated with IUGR[J]. Int J Gynaecol Obstet,2001,73: 229-235.
[9] Salafia CM, Charles AK,Mass EM. Placenta and fetal growth restriction[J]. Clin Obstet Gynecol,2006,49(2):236-256.
[10] Divon MY.Fetal growth restriction: diagnosis[EB/OL][2015-12-08]. http://www.uptodate.com/contents/fetal-growth-restriction-diagnosis?source=search_result&search=fetal+growth+restriction&selectedTitle=3~150.
[11] Robert PJ, Ho JJ, Valliapan J, et al. Symphysial fundal height (SFH) measurement in pregnancy for detecting abnormal fetal growth[J]. Cochrane Database Syst Rev,2012,7:CD008136.
[12] Resnik R. Fetal growth restriction: evaluation and management [EB/OL][2015-10-15]. http: //www.uptodate.com/contents/fetal-growth-restriction-evaluation-and-management?source=search_result&search=fetal+growth+restriction&selectedTitle=1~150.
[13] Baschat AA. Ductus venosus Doppler for fetal surveillance in high-risk pregnancies[J]. Clin Obstet Gynecol,2010, 53:858.
[14] Gülmezoglu AM, Hofmeyr GJ. Plasma volume expansion for suspected impaired fetal growth[J]. Cochrane Database Syst Rev,2000, CD000167.
[15] Abalos E, Duley L, Steyn DW. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy[J]. Cochrane Database Syst Rev, 2014, 2:CD002252.
(2015-12-10收稿 2016-01-05修回)
/
| 〈 |
|
〉 |