Giá trị tiên lượng trẻ sơ sinh nhỏ so với tuổi thai dựa trên chỉ số tốc độ tăng trưởng thai qua siêu âm 2 lần ở quý 3 của thai kỳ tại Bệnh viện Hùng Vương=The prognostic value for small - for - gestational - age infants based on the fetal growth velocity index using ultrasound twice during the third trimester of pregnancy at Hung Vuong Hospital

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Trung Nam Ngô, Thị Nhung Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.273-280

Bộ sưu tập: Metadata

ID: 243610

Thêm vào giỏ

Prognosis of small-forgestational- age infants aids in preparing resources for early support and reducing complications after birth. Objective: This study evaluates the prognostic value for small-forgestational- age infants based on the fetal growth velocity index in two consecutive ultrasound scans in the third trimester of pregnancy in pregnant women who underwent prenatal care and delivery at Hung Vuong hospital in 2023. Methods: This is a longitudinal cohort study among 164 pregnant women who underwent prenatal care and gave birth at Hung Vuong hospital. Participants underwent ultrasound scans to estimate the fetal weight for the first time from 32 to 32 weeks and six days, and the second time from 36 weeks to 36 weeks and six days, to calculate the fetal growth velocity index - which is used to predict the weight of an infant. Results: The fetal growth velocity index in two consecutive ultrasound scans in the third trimester of pregnancy for small-for-gestationalage infant prognosis reached 90% of sensitivity and 58.4% of specificity. Respectively, the negative predictive value reached 98.9% and positive predictive value reached 12.3%. The prognostic accuracy reached 60.4%. In general, the fetal growth velocity index at 32 to 32 weeks 6 days compared to 36 weeks to 36 weeks 6 days showed a good prognostic value with area under ROC curve AUC=0.83 (95%CI: 0.709 – 0.95). Calculating the fetal growth velocity index based on a model by Hugh and Gardosi is a simple approach to prognosis infant weight. Conclusion: Calculating the fetal growth velocity index is a good support for predicting infant’s weight. There is a need for a study with larger samples to expand the applicability for Vietnamese pregnant women.Siêu âm giúp tiên lượng trẻ sơ sinh nhỏ so với tuổi thai khi sinh là cần thiết vì giúp chuẩn bị nguồn lực để hỗ trợ sớm cho trẻ sau sinh và giảm biến chứng. Mục tiêu: Đánh giá giá trị tiên lượng trẻ sơ sinh có cân nặng nhỏ so với tuổi thai dựa trên chỉ số tốc độ tăng trưởng thai qua 2 lần siêu âm ở quí 3 của thai kỳ ở những thai phụ khám thai và sinh tại Bệnh viện Hùng Vương trong năm 2023. Phương pháp nghiên cứu: thiết kế nghiên cứu dọc tiến cứu trên 164 đối tượng nghiên cứu (ĐTNC) là thai phụ khám thai định kỳ và sinh tại Bệnh viện Hùng Vương. ĐTNC được siêu âm để ước lượng cân nặng thai nhi lần đầu vào tuổi thai 32 tuần đến 32 tuần 6 ngày và lần thứ hai ở tuần 36 đến 36 tuần 6 ngày để tính chỉ số tốc độ tăng trưởng. Dựa vào chỉ số tốc độ này để tiên lượng cân nặng trẻ sơ sinh lúc sinh. Kết quả: Chỉ số tốc độ tăng trưởng thai trên siêu âm 2 lần liên tiếp ở quý 3 nhằm tiên lượng trẻ sơ sinh nhỏ so với tuổi thai cho thấy độ nhạy cao 90% và độ đặc hiệu đạt 58,4%. Tương ứng, giá trị tiên đoán âm đạt 98,9% và giá trị tiên đoán dương thấp chiếm 12,3%. Độ chính xác chẩn đoán đạt 60,4%. Khả năng tiên lượng của chỉ số tốc độ tăng trưởng thai tuần 36 so với tuần 32 đã cho thấy mức giá trị cao với diện tích dưới đường cong ROC đạt AUC=0,830 (KTC 95% từ 0,709 đến 0,95). Việc tính toán chỉ số tốc độ tăng trưởng theo mô hình của tác giả Hugh và Gardosi là cách tiếp cận đơn giản để đánh giá cân nặng thai khi sinh. Kết luận: Tính chỉ số tốc độ tăng trưởng sẽ hỗ trợ tốt cho tiên đoán cân nặng thai khi sinh. Cần nghiên cứu cỡ mẫu lớn hơn để mở rộng khả năng áp dụng cho người Việt Nam.

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