RESUMO
OBJECTIVE: The aim of this study was to develop a nomogram for fetal urine production (UPR) using biometric parameters. METHODS: A cross-sectional study was performed in 110 normal singleton fetuses with gestational ages ranging from 20 to 40 weeks. UPR was measured using tridimensional ultrasound (3-DUS) virtual organ computer-aided analysis. UPR (ml/h) was calculated during the filling phase using the equation, UPR = (VFB2-VFB1)/time. The values for UPR were plotted as a function of fetal biometry (femur, humerus, abdominal circumference, and head circumference and biparietal diameter) to obtain a nomogram for each parameter. RESULTS: A total of 110 normal singleton fetuses with gestational age between 20 and 40 weeks were investigated. Five of them were excluded because the image quality was insufficient for correct visualization of the bladder contour. Linear regression analysis of UPR as a function of femur, humerus, abdominal circumference, and head circumference and biparietal diameter generated curves that represents the normal range for UPR by fetal biometry, and expressed by the following equations: (1) Humerus length (HL): ln (UPR) = -5.9546 + 0.0958 × HL (mm); (R(2) 0.6422); (2) abdominal circumference: ln (UPR) = -1.0981 + 0.158 × AC (mm); (R(2) 0.6328); (3) femur length: ln (UPR) = -1.5133 + 0.0803 × FL (mm); (R(2) 0.6611); (4) biparietal diameter ln (UPR) = -7.8779 + 0.2368 × BPD-0.0012 × DBP(2); (R(2) 0.7066). Although BPD has the highest correlation coefficient (R(2) 0.7066) there was no statistical significant difference between the parameters investigated for UPR prediction. CONCLUSION: The use of biometric parameters for prediction of fetal UPR seems to be useful and can avoid the necessity of building local nomograms for different populations. The same strategy should be considered to other fields in fetal medicine.
Assuntos
Biometria , Feto/fisiologia , Ultrassonografia Pré-Natal/métodos , Urina/fisiologia , Abdome/diagnóstico por imagem , Abdome/embriologia , Cefalometria , Estudos Transversais , Diurese , Feminino , Fêmur/diagnóstico por imagem , Fêmur/embriologia , Idade Gestacional , Humanos , Úmero/diagnóstico por imagem , Úmero/embriologia , Gravidez , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/embriologiaRESUMO
PURPOSE: This study was conducted to verify the predictive value of epiphyseal ossification center measurements in estimating gestational age. METHODS: Women with singleton pregnancies of 30-40 weeks gestation (n = 377) were enrolled in this prospective study. The distal femoral, proximal tibial, and proximal humeral ossification centers were identified and measured. A nomogram of fetal bone development was created using the sum of the three diameters. RESULTS: Gestational age correlated well with the diameters of the distal femoral and the proximal tibial epiphyseal ossification centers but even better with the sum of the three ossification centers. Positive predictive values of the fetus having gestational age of at least 37 weeks when the sum of the three centers was 7, 11, and 13 mm were 82%, 94%, and 100%, respectively. A nomogram was created using the sum of the ossification centers for 30-40 weeks' gestational age. CONCLUSIONS: Ultrasonographic visualization of the epiphyses ossification centers may be a useful marker of fetal gestational age.
Assuntos
Epífises/diagnóstico por imagem , Fêmur/embriologia , Idade Gestacional , Úmero/embriologia , Tíbia/embriologia , Adolescente , Adulto , Epífises/embriologia , Epífises/fisiologia , Feminino , Desenvolvimento Fetal , Humanos , Osteogênese , Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Ultrassonografia Pré-NatalRESUMO
Ultrasonographic examinations were performed on 1,000 pregnant women between the 28th and 40th weeks of gestation who had been seen at a private clinic. For all women the date of last menstruation was known, and none had obstetrical or clinical-surgical complications. All were singleton pregnancies, and cases of fetal malformation were excluded from the study. The proximal humeral epiphyseal ossification center was visualized significantly frequently after the 38th week (P < 0.001). With respect to a gestational age of more than 38 weeks, its specificity was elevated (99%), as also were its positive (91%) and negative (93%) predictive values. Its sensitivity, however, was low (58%). Routine determination of the proximal humeral ossification center is a valuable aid for the estimation of gestational age in the third trimester.
Assuntos
Úmero/diagnóstico por imagem , Osteogênese , Ultrassonografia Pré-Natal , Desenvolvimento Embrionário e Fetal , Epífises/diagnóstico por imagem , Feminino , Idade Gestacional , Humanos , Úmero/embriologia , Valor Preditivo dos Testes , Gravidez , Sensibilidade e EspecificidadeRESUMO
Foram analisadas 1000 ultrassonografias de rotina realizadas em gestantes normais, no período de janeiro a novembro de 1990. O núcleo de ossificaçäo epifisária fetal proximal do úmero apareceu de forma significante após a 38§ semana (p < 0,001), constituindo-se em recurso auxiliar valioso na avaliaçäo da idade gestacional no 3ª trimestre).