无创心排量NICOM在胎儿生长受限诊断中的应用.pptx

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1、1产科-胎儿生长受限FGRCheetahMedical2015CONTENT胎儿生长受限是啥WhatisFoetalGrowthrestriction胎儿生长受限风险人群WhoisatriskofFGR胎儿生长受限的发展DevelopmentofFGR妊娠毒血症WhatisPre-eclampsia事实和数据FactsandFigures治疗Currenttreatment临床研究ClinicalStudiesNICOM的机遇opportunities2Additionally,maybereferredtoIntrauterineGrowthRestriction(IUGR

2、)FGR是围产期出生前后立即病发和死亡的主要病症(immediatelybeforeorafterbirth)mortalityandmorbidity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%-10ofallpregnancies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Increaseinallmajorcausesoffoetalmorbidity特别的，也与后期的身体不健康相关Additionally,associatedwithpoorerhea

3、lthinlaterlife3References;FoetalGrowthRestriction–MichaelRoss–Nov.2015Maternaldemographics&haemodynamicsforthepredictionofFGRatbooking–NickKemetas2015胎儿生长受限-风险4孕妇年龄MaternalAge吸烟Smokers药物和酒精Drugusersandalcohol多胎妊娠Multiplegestations胎儿生长受限的历史PrevioushistoryofFGR糖尿病Diabetes营养缺乏Poornutrition妊娠高血

4、压综合征Pregnancyinducedhypertension胎盘和脐带异常Placental/UmbilicalcordabnormalitiesAllfoetusatorbelowthe10thpercentileareathighriskofpotentiallydevelopingpreventableperinataldeathapproximately40%40%areconstitutionallysmall20%offoetus’sareintrinsicallysmallsecondarytochromosomalorenvironmentalaetiol

5、ogyReference:FoetalGrowthRestriction–MichaelRoss5FGRCONSEQUENCESDiagnosis:Mostcommonandsimplest–measuringthedistancefromthemother’sfundustothepubicbone–performedafter20weeksgestation(proventobe50%accurate)InthepresenceofsignificantriskfactorsforFGR;amnioticfluidvolumeandumbilicalarterydoppl

6、erisrecommendedfrom26weeksgestationin2-4weeklyintervalsReference;ClinicalPractiseguidelinesforFGR–Instituteofobstetricians&Gynaecologists,HealthServiceExecutive–UK&IrelandObstetrics-Gynaecology&WomensHealth–DetectionandsurveillanceofIUGR–Oct.2013;DanielleTateetalTimingofthedeliveryofaFGRbab

7、yposesaseriousdilemma:todeliverearlyexposestheneonatetomorbidityassociatedwithimmaturitytodelivertoolaterisksseriousadditionalmorbiditysecondarytofoetalhypoxia5Pre-eclampsiaDefinition;Diastolicbloodpressureismorethan90mmHgonatleast2xoccasions4hoursaparti