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INVENTION
Patent of the Russian Federation RU2066975
METHOD FOR DETERMINING THE STATUS OF FRUIT IN THE DURIOUS PERIOD
The name of the inventor: Anufrieva Vera Grigoryevna
The name of the patent owner: Anufrieva Vera Grigoryevna
Address for correspondence:
Date of commencement of the patent: 1991.12.10
The invention relates to medicine, namely obstetrics, and can be used to determine the condition of the fetus. SUMMARY OF THE INVENTION: determine the weight of the fetus according to the original formula for 30-42 weeks of pregnancy, then determine the normal weight of the fetus for a given period of pregnancy, taking into account the growth of pregnant women and establish the stage of hypotrophy, paratrophy, comparing the normal and actual fetal masses.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, namely to perinatology and relates to improving the accuracy of the method.
In the well-known paper (1), it is noted that for the purpose of early diagnosis of fetal hypotrophy, ultrasound scanning of the uterus is carried out at 33.37 weeks of pregnancy, the outer and inner diameters of the small contour of the uterus, its hemispheres, the height of the cone are determined, and the volume of the muscular mass of the uterus is then calculated by the formula. In the pathological course of pregnancy, which caused a lag in the development of the fetus, the volume of the muscular uterus continues to remain below physiological values.
However, this method does not take into account the mass of the fetus, there are no clear criteria by which it is possible to judge the degree of fetal hypotrophy.
Another group of co-authors (2) made an attempt to determine the size of the head (D), the length of the femur (DB), the mean transverse size of the heart (C), and the abdomen (A) in determining the fetal mass. Determine the mass of the fetus according to the following formula:
M = 186.6xГ 2 -3490.3xГ + 43.9хА 2 -717.8хА + 615.0хС + 243.8хДБ + 17849.0.
This method is inconvenient for use in practical obstetrics, since it includes numerous ultrasonic fetometric indicators and requires complex calculations.
The possibility of predicting fetal hypotrophy by several ultrasonic fetometric indicators was undertaken in 1991 by another group of researchers (3). The authors developed normative tables and curves for ultrasonic biometric parameters of the fetus at the time of 20.42 weeks of gestation. When using the method of sliding percentile standards, each parameter of ultrasonic biometry makes it possible to determine the correspondence of the fetal dimensions to gestational age, and the degree of their deviation from the standard values. The prognosis of the birth of a child with a low body weight is revealed from the data of ultrasound and their correlation with the mass of the newborn. This method allows you to predict the birth of a child with hypotrophy in 78% of cases and in 75% correctly predict the birth of a child with normal weight. This method is taken for the prototype as the closest to the proposed method.
Disadvantages of the prototype:
1) percentile tables and curves of ultrasonic ferrometric parameters of the fetus are considered as standards without taking into account the growth of the pregnant;
2) there is no normative table for the weight of the fetus taking into account the growth of the pregnant woman.
The purpose of the invention is to perform an early diagnosis of fetal mass by increasing the accuracy of the method.
The fetal mass is determined from the quasilinear dependence obtained from the fetometric parameters of the fetus for 30.42 weeks of gestational age, taking into account the growth of the pregnant and normative table, and the severity of fetal hypotrophy and paratrophy is assessed by deviating from the values of this table.
The normative table is compiled for the most commonly used in obstetrical practice fetometric parameters of the fetus (biparietal size of the head, transverse diameter of the abdomen) with median values (50%) with a period of 30.42 weeks gestational age, taking into account the growth of the pregnant (see Table 1 in Appendix 1) . Based on the revealed quasi-linear relationship between the transverse diameter of the abdomen, the biparietal size of the fetal head and the mass of the newborn (see graph No. 1 in Appendix No. 2), a formula was obtained to determine the normal weight of the fetus at a period of 30.42 weeks gestational age: When using median fetometric parameters (P 50 ) in formula N 1, taking into account the growth of the pregnant woman for full weeks of gestational age of the fetus (D = 0), the normative values of fetal mass with median parameters (P 50 ) were obtained (see Table N 1 in Appendix N 1). |
- Tables -
Essential features of the method, which are absent in the prototype, are not known in the known analogs.
The method is carried out as follows.
The normal weight of the fetus (MPH) for the corresponding gestational age for a given pregnancy height is calculated using the normative values of the fetus weight according to Table N 1 (MP 1 ) (see Appendix No. 1):
MP n = MP 1 + 25 × D (2).
The estimated weight of the fetus (MP n ) is determined from Table N 2 (MP 2 ) (see Appendix No. 3), which summarizes the results of calculations of the fetal mass from ultrasonic biometry:
MP n = MP 2 .
Clinical evaluation of fetal development is unified by comparing the expected and normal fetal mass for the corresponding gestation period and the given pregnancy height. The fetus is considered normotrophic if there is a deviation in the estimated weight of the fetus from normal to 10% (up to 2 weeks). The fetus is considered to be hypotrophic if the estimated fetal weight is less than normal by 10% or more: I degree from 10% to 15% (from 2 to 3 weeks), II degree from 15% to 20% (from 3 to 4 weeks), III degree by 20% or more (for 4 weeks or more). The fetus is considered paratrophic if the estimated fetal mass is more than normal by 10% or more: I degree from 10% to 15% (from 2 to 3 weeks). II degree from 15% to 20% (from 3 to 4 weeks), III degree by 20% or more (for 4 weeks or more).
Example 1 . Pregnant Parfirova O.V. 18 years. I.B. N 46629, height 162 cm. Last monthly. 07.01.91. The ultrasound examination was carried out on October 17, 911. BPR 94 mm, DZ 106 mm, 21.10.91 a boy with a weight of 3400 was born.
The ultrasound was performed at the gestational age of the fetus of 40 weeks and 2 days. The normal weight of the fetus at the gestational age of 40 weeks and the growth of the mother 162 cm according to Table N 1 (see Appendix No. 1) is 3410 g.
The normal weight of the fetus for the gestational age of 40 weeks and 2 days is calculated by the formula N 2:
MP n = 3410 + 25x2 = 3460 g.
The estimated weight of the fetus is determined from Table N 2 (see Appendix No. 3):
MP n = 3260 g.
The estimated weight of the fetus is less than the normative: 3460-3260 = 200 g (5.8%). At a period of 40 weeks and 2 days of gestation in this pregnancy, with an increase of 162 cm, the birth of a child with normal body weight is predicted.
Checking. The birth of the boy occurred at the gestational age of 40 weeks and 6 days. The normal weight of the fetus for this src of gestation is calculated by the formula N 2:
MP n = 3410 + 25x6 = 3560 g.
The actual weight of the newborn is less than the normative: 3560-3400 = 160 g (4.5%). The true mass of the newborn for this gestational age and the growth of the mother corresponds to the normal mass.
Example 2 . Pregnant Bialik TE 21 years old. I.B. N 46608. The growth is 158 cm. The last one was monthly. 04.01.91. The ultrasound examination was carried out on 16.10.91. BPR 85 mm, DZ 86 mm. 31.10.91 a girl was born in the mass of 2000.
Ultrasound was performed at a gestation period of 40 weeks and 5 days. The normal weight of the fetus at a gestational age of 40 weeks and a mother's height of 158 cm according to Table No. 1 (see Appendix No. 1) is 3280 g.
The normal weight of the fetus for the gestational age of 40 weeks and 5 days is calculated by the formula N 2:
MP n = 3280 + 25x5 = 3405 g.
The estimated weight of the fetus is determined from Table N 2 (see Appendix No. 3):
MP n = 2030.
The estimated weight of the fetus is less than the normative: 3405-2030 = 1375 g (40.4%). This pregnant woman with a gestation period of 40 weeks and 5 days with a height of 158 cm predicts the birth of a child with grade III hypotrophy.
Checking. The girl's birth took place at the gestational age of 42 weeks and 4 days. The normal weight of the fetus for this gestation period is calculated by the formula N 2:
MP n = 3540 + 25x4 = 3640 g.
The actual weight of the newborn is less than the normative: 3640-2000 = 1640 g (45.1%). The true mass of the newborn for this gestational age and the growth of the mother corresponds to grade III hypotrophy.
Example 3 . Pregnant Kochkina V.V. 30 years. I.B. N 46549. Height 165 cm. Last monthly 02.02.91. Ultrasound examination was carried out on 10.10.91. BPR 92 mm. DZ 106 mm. On 16.10.91, a girl of 3300 was born.
Ultrasound was performed at a gestation period of 35 weeks and 4 days. The normal weight of the fetus for 35 weeks of gestational age with the growth of a pregnant woman of 165 cm according to Table No. 1 (see Appendix No. 1) is 2660 g.
The normal weight of the fetus for the gestational age of 35 weeks and 4 days is calculated by the formula N 2:
MP n = 2660 + 25x4 = 2760 g.
The estimated weight of the fetus is determined from Table N 2 (see Appendix No. 3):
MP n = 3120 g.
The estimated weight of the fetus is more than normative: 3120-2760 = 360 g (13%). This pregnant woman with a gestation period of 35 weeks and 4 days predicts the birth of a child with paratrophy of the I degree.
Checking. The girl's birth occurred at the gestational age of 36 weeks and 3 days. The normal weight of the fetus for a given gestation period with a mother's height of 165 cm is calculated by the formula N 2:
MP n = 2890 + 25x3 = 2965 g.
The real weight of the newborn is more than normative: 3300-2965 = 335 g (11.3%). The true mass of a newborn for a given gestational age with a 165 cm birth corresponds to paratrophy of the first degree.
The data of clinical observations were carried out in 1280. It was found that in 84% of cases the true mass of the newborn differed from the calculated antenatally less than 5% in 96% by less than 10%. The average error in determining the fetal mass to 100 g was noted in 82% of the observations and In 94% of observations to 200 g. This method allows to predict the birth of a child with hypotrophy in 89.6% of observations, with a normal mass of 98.8% with paratrophy - 80.4% The predicted degree of severity of fetal hypotrophy coincided in newborns in 86.3% Observations, with paratrophy 83.9%
The implementation of the proposed method for determining the weight of the fetus during the prenatal period allows the body weight of the newborn to be predicted with high accuracy at a gestational age of 30.42 weeks, to unify the clinical evaluation of fetal development taking into account gestational age and maternal growth, and timely to perform therapeutic and prophylactic measures in the case of impaired fetal development. The use in this method of such an important factor as the growth of a pregnant woman facilitates the implementation of the most rational method of introducing births in order to reduce the traumatism and complications in newborns. The method is quite simple in comparison with the known ones, it is convenient for practical use in obstetrics.
CLAIM
A method for determining the fetal condition in the prenatal period, comprising using ultrasound biometrics to determine the fetal weight, characterized in that the fetal mass for 30 42 weeks of gestation is determined by the formula
MP 70 х БПР + 30 х ДЖ + 25Д 6500,
Where MP is the mass of the fetus, g;
BPR biparietal head size, mm;
Diameter of the abdomen, mm;
25 mean daily weight gain of fetus, g;
D number of days with full weeks of pregnancy,
Then determine the normal weight of the fetus for a given period of pregnancy, taking into account the gradation of growth in pregnant women from 145 to 148 cm, from 149 to 152 cm, from 153 to 156 cm, from 157 to 163 cm, from 164 to 167 cm, from 168 to 171 cm And from 172 to 175 cm and establish the first degree of severity of hypotrophy and paratrophy in the deviation of the actual mass from normal 1 to 15% of hypotrophy, paratrophy of grade II with a deviation of the actual mass from normal from 15 to 20%, and III degree of hypotrophy, paratrophy in the deviation of 20% or more.
print version
Date of publication 27.03.2007gg
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