Mục tiêu nghiên cứu
Ngưỡng cân nặng liên quan đến đẻ khó do thai to là trên 3650g, tương ứng với đường bách phân vị 90 ở tuổi thai 40 tuần với các giá trị chẩn đoán là độ nhạy 77% và độ đặc hiệu 78%
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- Điều hướng trang này:
- - TTTC, thai to và thai bình thường.
- INTRODUCTION
- 1.1.1. Embryological development stage
- 1.2.4. Study design to create the standard foetal growth chart
- 1.6.1. Use of percentile chart of neonatal anthropometric indices in diagnosing foetal intrauterine growth retardation.
2.3. Ngưỡng cân nặng liên quan đến đẻ khó do thai to là trên 3650g, tương ứng với đường bách phân vị 90 ở tuổi thai 40 tuần với các giá trị chẩn đoán là độ nhạy 77% và độ đặc hiệu 78%.KIẾN NGHỊỨng dụng các biểu đồ bách phân vị về cân nặng, chiều dài, vòng đầu và chỉ số cân nặng-chiều dài để chẩn đoán thai bất thường về cân nặng. Đặc biệt biểu đồ bách phân vị về cân nặng nên dùng như là công cụ chính để chẩn đoán thai CP.- TTTC, thai to và thai bình thường.Dựa vào biểu đồ bách phân vị về cân nặng thai theo tuổi thai sẽ thực hiện và giải quyết được nội dung quan trọng :- Xác định được tỉ lệ thai CPTTTC- Xác định được tỉ lệ thai toTừ đó là 2 tiền đề làm cơ sở cho nghiên cứu các yếu tố liên quan tác động làm tăng tỉ lệ thai CPTTTC, từ đó có biện pháp giảm thiểu tỉ lệ thai CPTTTC và tai biến do thai to, làm cơ sở cho sự chỉ đạo và hoạch định các chương trình và kế hoạch liên quan đến xã hội.INTRODUCTIONThe size and weight of newborn infants is the most important factors related to the health of children at short term as well as the long term. The low birth weight always increases the risk of morbidity and mortality in the neonatal period as well as adultd. In the opposite, the large for age babies relate to birth axphysia and trauma. The classification of the infant at high risk based on the birth weight by GA (GA) is an important issue which has been concerned and give priority by the Wold Health Organization (WHO) to reduce the rate of morbidity and mortality all over the world. Of which, the infant small for GA related to complications and death called intrauterine growth retardation (IUGR). To determine the ratio of IUGR, it is based on birth weight pecentile chart. The developed countries have their own birth weight percentils. Otherwise, there has not yet that type of chart in Vietnam, so it is impossibe to know the ratio of IUGR in the population in order to have plan on prevention and management. The desire of reseach is to create the growth charts of Vietnamese birth anthropometric indice by GA to deliver a tool for classifing the newborn appropriate, small and large for GA.
1. To define the percentile values of some anthropometric indice of newborn infant by GA at National Obstetric and Geneacology Hospial and Hai Phong Obstetric and Geneacology Hospial 2. To assess the applicated value of percentile charts: defining the abnormal cut-off of anthropometric measurement mentioned above.
1. Determine the rules of the development of Vietnamese birth anthropometric measurements by GA from 28-42 weeks. It is the first study in Viet Nam that created birth lenght, head circumference and ponderal index perceltiles charts by GA from 28-42 weeks. 2. Determine the Vietnamese birth weight and poderal index percentile cut- off in defining fetal small or large for GA.
There are 138 pages, including: Introduction (2 pages); Chapter 1. Overview (36 pages); Chapter 2. Methods and object of reseach (15 pages); Chapter 3. The results (50 pages); Chapter 4. Discussion (32 pages); Conclution (2 pages); Recommendations (1 page); Reference: 118 documents, including 21 Vietnamese documents and 97 English documentation. Chapter 1. OVERVIEW 1.1. Intrauterine development of foetus’ shape and size. 1.1.1. Embryological development stage1.1.2. Foetal development stage1.1.3. Methods of measuring foetus’s shape and size development1.1.3.2. Foetal growth measured with ultrasonography 1.1.3.3. Assess the fetal growth by using percentile anthropometric indices chart 1.2. Growth chart of neonatal anthropometric indices by GA. According to WHO (1995), there are four criterias used to create a fetal growth chart by GA, namely: method of calculating GA, research population, sample size and method of chart/graph building. 1.2.1. Method of calculating GA 1.2.2. Research population 1.2.3. Sample size
1.2.5. Classification of neonatal anthropometric indice growth chart.1.3. Studies in birth weight by GA In the USA, in 1963 Lubchenco et al initially created birthweight chart by GA. As the gestational growth indices differ among races and geographic conditions and they vary corresponding with nutritional status as well as economic, social condition and educational level, thus from 1963 until now, there have been many authors taking effort to do researches to create a standard foetus and birthweight growth chart in diferrent countries including a project involved by 8 countries which is in the process to be done. In Viet Nam, almost reseachers have been keen on studying mean value of full term birthweight. In 2001, Đỗ Thị Đức Mai studied anthropometric indices of 3847 newborns with 28-43 weeks of GAs born in Ha Noi Obstetrics and Gynecology Hospital. The authors measured weight, head circumference, length, breast circumference, arm circumference of the neonates. GA is only calculated by using the last menstrual period and the number of preterm babies in that study was small. The database was only used to calculate mean and standard deviation of anthropometric indices. The birth weight growth chart according standard deviation in each GA ( In 2005, Phan Trường Duyệt et al first created fetal weight growth chart by GA from 12-44 weeks. However, the authors have not created the Vietnamese birth length and head circumference. In addition, the database used in the study was collected from various studies which differs in research subjects and studying time. 1.4. Birth length by GA and birth length growth chart. The harmony between birth length and weight have an important role in evaluating newborn health status. After creating birth weight chart in 1963, Lubchenco continued to create the birth length chart by GA in 1966. The length of 4716 newborns with GA from 24 to 43 weeks born in Colorado Hospital (The US) was measured. For Luchenco, weigh-length ratio was calculated by using Rohrer’s formula (Rohrer’s ponderal index): weight(gr)x100/(length)3(cm). The index follows the 3-dimentional geometry rules. In general, this index shows the relation between birthweight and birthlength by GA. Thus, if the index is high, then it means that the newborn have an excessive weight in comparison with his length and vice versa. 1.5. Birth head circumference by GA and birth head circumference chart. The measures of a birth weight, length and head circumference plotted in the growth chart not only indicate whether his/her weight is low or high by his/her GA but also enable us to evaluate the intrauterine environment where he/she grew. A newborn has a low birthweight but a normal length and head circumference by GA may be due to poor nutritional supply in the uterus caused by placental dysfunction. A baby have a low birthweight and at the same time, corresponding with a low length and head circumference by GA may be normal (due to his/her normal constitutional formation or genetic factor/family factor) or abnormal resulting from gestational problems in the first 3 months of gestation (eg: intrauterine infections, chromosomal abnormalities) For preterm newborns, the growth chart of fetal weight may be applied in the same way as neonatal growth chart. It can help to compare the real weight gain of a fetus in the uterus with a model of the ideal weight gain of the same GA. This comparison has its special meaning as the growth of head circumference of a fetus has a strong correlation with the development of his/her intelligence in the future. If the fetal head circumference increases normally, Its intelligence development may not be affected even the weight under the standard curve.
1.6.1.2. Meaning of percentiles in fetal growth chart.Most of authors agreed about the definition of low birthweight by GA in which a fetal weight is under the 10th percentile by GA is indentified “low”. The neonatal mortality of newborns with low birthweight by GA is higher than that of newborns with normal birthweight by GA. For example, by the GA of 38 weeks, the mortality of low birth weight newborns is 1% while that number is 0,2% in the group with normal birthweight. However, there are low birthweight neonates by GA whose birthweight is under the 10th percentile by GA, who are not abnormal fetal intrauterine growth retardation but affected by constitutional factor (eg: newborn of short and small mothers are often low birthweight). Therefore, to estimate the cut off value of birthweight to diagnose pathological fetal intrauterine growth retardation, some authors had studied to find out the percentile of birthweight which have strong correlation with mortality and morbidity in neonatal period. Каталог: images -> ngcuusinh images -> Céng hßa x· héi chñ nghÜa viÖt nam Độc lập tự do hạnh phúc images -> Lúa gạo Việt Nam Giới thiệu images -> Trung Tâm kt tc-đl-cl images -> Số: 105/2008/QĐ-ttg CỘng hòa xã HỘi chủ nghĩa việt nam độc lập Tự do Hạnh phúc images -> ChuyêN ĐỀ ĐẠi số TỔ HỢP, XÁc suất kiến thức cơ bản Đại số tổ hợp images -> BỘ giáo dục và ĐÀo tạo trưỜng đẠi học luật tp. HỒ chí minh dưƠng kim thế nguyên thủ TỤc phá SẢn các tổ chức tín dụng theo pháp luật việt nam images -> Review of Condor, Sun Grid Engine and pbs tải về 0.85 Mb. Chia sẻ với bạn bè của bạn:
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