目的:探讨无并发症妊娠中晚期胎儿胰腺的超声成像及其与妊娠结局的关系。
方法:这是一项前瞻性队列研究,包括274名孕妇。研究包括妊娠晚期(28-40周)的无并发症妊娠。孕产妇慢性病,妊娠相关疾病,如高血压,糖尿病,胆汁淤积,吸烟,胎儿异常被确定为排除标准.在所有参与者中评估超声检查胎儿胰腺测量和回声。对于观察者内的可靠性,每个参与者的胎儿胰围被测量两次。将胰腺的回声与肝脏和肋骨进行比较,并分为1、2和3级。所有参与者的妊娠结局均来自医院数字登记系统。
结果:妊娠晚期的平均胎儿胰围为70.7±0.6mm(中位数,70[44-100.7]),具有较高的观察者内部一致性(ICC0.996[0.995;0.997])。胰围之间呈显著正相关,体重指数(BMI),胎龄,出生体重。在包括至少一种呼吸窘迫综合征的复合不良结局病例中,胰腺测量值明显更高。高胆红素血症,新生儿肺炎,感染,和脓毒症(p<0.001)。胰腺回声与围产期结局之间没有关系。
结论:胎儿胰腺大小与胎龄呈正相关,BMI,出生体重,胎儿胰腺大小增加与新生儿复合不良结局相关.
OBJECTIVE: To examine third-trimester sonographic imaging of the fetal pancreas in uncomplicated pregnancies and its association with pregnancy outcomes.
METHODS: This was a prospective cohort study including 274 pregnant women. Uncomplicated pregnancies in the third trimester (28-40 weeks) were included in the study. Maternal chronic disease, pregnancy-related disorders such as hypertension, diabetes, cholestasis, smoking, and fetal abnormalities were determined as exclusion criteria. Sonographic fetal pancreatic measurement and echogenicity were evaluated in all participants. For intra-observer reliability, each participant\'s fetal pancreatic circumference was measured two times. The echogenicity of the pancreas was compared with the liver and ribs and classified as grade 1, 2, and 3. The pregnancy outcomes of all participants were obtained from the hospital digital registration system.
RESULTS: The average fetal pancreatic circumference in the third trimester was 70.7 ± 0.6 mm (median, 70 [44-100.7]), with high intra-observer agreement (ICC 0.996 [0.995; 0.997]). A significant positive correlation was found between pancreatic circumference, body mass index (BMI), gestational age, and birth weight. Pancreatic measurements were significantly higher in composite adverse outcomes cases that included at least one of respiratory distress syndrome, hyperbilirubinemia, neonatal pneumonia, infection, and sepsis (p < 0.001). No relationship was found between pancreatic echogenicity and perinatal outcomes.
CONCLUSIONS: Fetal pancreas size was positively correlated with gestational age, BMI, and birth weight, and increased fetal pancreas size was associated with composite adverse neonatal outcomes.