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Ⅰ はじめに
胎児の発育は,母体・胎児・胎盤の代謝相関により調整されており,子宮内環境の恒常性の変化は胎児の発育に強く影響すると考えられる.子宮内胎児発育遅延(IUGR=Intra Uterine Growth Retardation)と出生後のSFD(Small for date's infant)は児の予後に影響が大きいので妊婦管理上,新生児管理上,しばしば問題となるところである.
新生児の発育は,在胎期間,出生時体重・身長,身体各部の計測,成熟徴候の観察などにより総合的に判定される.しかし,子宮内胎児の発育判定の場合には,直接胎児を計測したり,成熟徴候を観察することはできない.
児体重の推定法についても諸家により報告されている.主なものをまとめると,胎児発育判定法は表1,新生児体重の推定方法は表2のとおりである.現在では,超音波断層法の導入により胎児情報を把握できるようになり,児頭大横径や胸郭横径等から児体重を換算し好成績を得るようになった.
しかしながら,子宮内羊水中で生存発育を続けている胎児の発育を的確に判定したり,正確に児体重を推定できる単一の方法はME機器の発達した今日においても見当らない.
そこで,児体重の推定方法について,4つの方法を比較し,誤差範囲について検討したので報告する.
Abstract
Development of the newborn infant is estimated by gestational ages, liveborn birthweight and stature, another measurement and maturation's sign.
But for 9 months the intrauterine fetal to be grows unseen. Maturation of fetal infant is prominently associated with gestational ages. Only has it been recognized that in a given infant the degree of maturation of any one organ system could be relatively accelerated or delayed.
Obstetrics made recently remarkable progress for the medical electronics. However, fetal growth estimation and presumption of the newborn birthweight are difficult. Intrauterine growth retardation and small-for-dates infant that must be prevent. Maternal and child health care is very important to midwife.
This time, I was presumption of the newborn birthweight by next method.
1 Biporietal diameters of the fetus head by diagnostic ultrasound (electronic scan)
Y=900X-5,200
2 Jacobson's formula W=(F-12)×155
3 Araki's formula W=(124.4F)-985.0
4 an overall presumption by midwife students
Consequently, an overall presumption was nearly newborn birthweight, so that presumption of the newborn birthweight must be estimated by gestational ages, developmental curve of fundus uteri, biporietal diameters of the fetus head and anothers.
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