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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5802_Библиотеки_им_академика_М_И_Перельмана.pdf
Obstetrics
326
FURTHER READING
Hadlock FP, Deter RL, Harrist RB, Park SK. Fetal abdominal
circumference as a predictor of menstrual age. Am J Roentgenol.
1982; 139:367–370.
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Obstetrics
328
Fetal femur length
PREPARATION
Full bladder for transabdominal imaging in 2
nd
trimester.
POSITION
Mother is in the supine position. Long axis image of fetal femur.
TRANSDUCER
Transabdominal 3.0–6.0 MHz curvilinear transducer.
METHOD
The long axis of the femoral shaft is measured with the ultrasound
beam perpendicular to the shaft, excluding the femoral epiphyses.
APPEARANCE
The correct position of the transducer along the femoral long axis is
conrmed by identifying the femoral condylar epiphysis plus either the
femoral head epiphysis or greater trochanter within the same plane.
MEASUREMENTS
10 12.6
11 12.9
12 13.3
13 13.6
14 13.9
15 14.1
16 14.6
17 14.9
18 15.1
19 15.6
20 15.9
21 16.3
Femur length measured in the long axis (cursors).
22 16.6
23 16.9
24 17.3
25 17.6
26 18.0
27 18.3
28 18.7
29 19.0
30 19.4
31 19.9
32 20.1
33 20.6
34 20.9
35 21.1
36 21.6
37 22.0
Fetal femur length
329
Obstetrics
330
38 22.4
39 22.7
40 23.1
41 23.6
42 23.9
43 24.3
44 24.7
45 25.0
46 25.4
47 25.9
48 26.1
49 26.6
50 27.0
51 27.4
52 27.9
53 28.1
54 28.6
55 29.1
56 29.6
57 29.9
58 30.3
59 30.7
60 31.1
61 31.6
62 32.0
63 32.4
Fetal femur length
64 32.9
65 33.4
66 33.7
67 34.1
68 34.6
69 35.0
70 35.6
71 35.9
72 36.4
73 36.9
74 37.3
75 37.7
76 38.1
77 38.6
78 39.1
79 39.6
331
FURTHER READING
Jeanty P, Rodesch F, Delbeke D, Dumont JE. Estimation of
gestational age from measurements of fetal long bones. J
Ultrasound Med. 1984; 3:75–79.
Obstetrics
332
Multiple fetal parameters in the
assessment of gestational age
PREPARATION
Full bladder for transabdominal imaging in 2
TRANSDUCER
Transabdominal: 3.0–5.0 MHz curvilinear transducer.
METHOD
Simple averaging technique: Take the four estimates of age by using
bi-parietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL), then add them together, and
divide by four.
Regression equations: For predicting menstrual age from any combination of these measurements (from 12–42 weeks)
Menstrual Age in Weeks = 10.85 + 0.060 (HC) (FL) +
0.6700 (BPD) + 0.1680 (AC)
Standard Deviation = 1.02 weeks.
MEASUREMENTS
12.0 17 68 46 7
12.5 19 75 53 9
13.0 21 82 60 11
13.5 23 89 67 12
14.0 25 97 73 14
14.5 27 104 80 16
15.0 29 110 86 17
nd
trimester.
Multiple fetal parameters in the assessment of gestational age
15.5 31 117 93 19
16.0 32 124 99 20
16.5 34 131 106 22
17.0 36 138 112 24
17.5 38 144 119 25
18.0 39 151 125 27
18.5 41 158 131 28
19.0 43 164 137 30
19.5 45 170 144 31
20.0 46 177 150 33
20.5 48 183 156 34
21.0 50 189 162 35
21.5 51 195 168 37
22.0 53 201 174 38
333
23.0 56 213 185 41
23.5 58 219 191 42
24.0 59 224 197 44
24.5 61 230 202 45
25.0 62 235 208 46
25.5 64 241 213 47
26.0 65 246 219 49
26.5 67 251 224 50
27.0 68 256 230 51
27.5 69 261 235 52
Obstetrics
334
28.0 71 266 240 54
28.5 72 271 246 55
29.0 73 275 251 56
29.5 75 280 256 57
30.0 76 284 261 58
30.5 77 288 266 59
31.0 78 293 271 60
31.5 79 297 276 61
32.0 81 301 281 62
32.5 82 304 286 63
33.0 83 308 291 64
33.5 84 312 295 65
34.0 85 315 300 66
34.5 86 318 305 67
35.5 88 325 314 69
36.0 89 328 318 70
36.5 89 330 323 71
37.0 90 333 327 72
37.5 91 335 332 73
38.0 92 338 336 74
38.5 92 340 340 74
39.0 93 342 344 75
39.5 94 344 348 76
40.0 94 346 353 77
Multiple fetal parameters in the assessment of gestational age
FURTHER READING
Hadlock FP. Sonographic estimation of fetal age and weight. Radiol
Clin North America. 1990; 28:39–50.
Hadlock FP, Deter RL, Harrist RB, Park SK Estimated fetal age:
Computer-assisted analysis of multiple fetal growth parameters.
Radiology. 1984; 152:497–501.
335