无创心排量NICOM在胎儿生长受限诊断中的应用讲解.pptx

1 产科 -胎儿生长受限FGR Cheetah Medical 2015 CONTENT 胎儿生长受限是啥What is Foetal Growth restriction 胎儿生长受限风险人群Who is at risk of FGR 胎儿生长受限的发展Development of FGR 妊娠毒血症What is Pre-eclampsia 事实和数据Facts and Figures 治疗Current treatment 临床研究Clinical Studies NICOM的机遇 opportunities 2 Additionally, may be referred to Intrauterine Growth Restriction(IUGR) FGR是围产期出生前后立即病发和死亡的主要病症 (immediately before or after birth) mortality and morbidity 胎儿生长受限(FGR) 胎儿不能达到其基因确定的大小胎儿在子宫停止生长或放慢出现围产期并发症包括发病和死亡发病率5% - 10of all pregnancies 胎儿生长受限依然生产时死胎和婴儿死亡增加3-7 倍 败血症发生也增加3-7 倍 增加所有病因的死亡率Increase in all major causes of foetal morbidity 特别的，也与后期的身体不健康相关Additionally, associated with poorer health in later life 3 References; Foetal Growth Restriction – Michael Ross – Nov. 2015 Maternal demographics haemodynamics for the prediction of FGR at booking – Nick Kemetas 2015 胎儿生长受限- 风险 4 孕妇年龄Maternal Age 吸烟Smokers 药物和酒精Drug users and alcohol 多胎妊娠Multiple gestations 胎儿生长受限的历史Previous history of FGR 糖尿病Diabetes 营养缺乏Poor nutrition 妊娠高血压综合征Pregnancy induced hypertension 胎盘和脐带异常Placental/Umbilical cord abnormalities All foetus at or below the 10th percentile are at high risk of potentially developing preventable perinatal death approximately 40% 40% are constitutionally small 20% of foetus’s are intrinsically small secondary to chromosomal or environmental aetiology Reference: Foetal Growth Restriction – Michael Ross 5 FGR CONSEQUENCES Diagnosis: Most common and simplest – measuring the distance from the mother’s fundus to the pubic bone – performed after 20 weeks gestation (proven to be 50% accurate) In the presence of significant risk factors for FGR; amniotic fluid volume and umbilical artery doppler is recommended from 26 weeks gestation in 2-4 weekly intervals Reference; Clinical Practise guidelines for FGR – Institute of obstetricians Gynaecologists , Health Service Executive – UK Ireland Obstetrics-Gynaecology Womens Health – Detection and surveillance of IUGR – Oct. 2013; Danielle Ta