标准·指南·方案
ENGLISH ABSTRACT
胎儿生长受限临床诊治标准化表单管理专家共识
中华医学会围产医学分会胎儿医学学组
中华医学会妇产科学分会产科学组
国家重点研发计划《建立我国胎儿生长曲线和胎儿生长受限干预体系的全链条研究》部分项目骨干
作者及单位信息
·
DOI: 10.3760/cma.j.cn113903-20241112-00754
Expert consensus on the standardized checklists for clinical diagnosis and management of fetal growth restriction
Fetal Medicine Subgroup, Society of Perinatal Medicine, Chinese Medical Association
Obstetrics Subgroup, Society of Obstetrics and Gynecology, Chinese Medical Association
Core Members of the National Key Research and Development Program "Integrated Research on Establishing Fetal Growth Curves and an Intervention System for FGR in China"
Sun Luming
Duan Tao
Yang Huixia
Qi Hongbo
Authors Info & Affiliations
Fetal Medicine Subgroup, Society of Perinatal Medicine, Chinese Medical Association
Obstetrics Subgroup, Society of Obstetrics and Gynecology, Chinese Medical Association
Core Members of the National Key Research and Development Program "Integrated Research on Establishing Fetal Growth Curves and an Intervention System for FGR in China"
Sun Luming
Department of Fetal Medicine, Obstetrics and Gynecology Hospital of Tongji University, Shanghai 200092, China
Duan Tao
Department of Obstetrics, Obestetrics and Gynecology Hospital of Tongji University, Shanghai 201204, China
Yang Huixia
Department of Obstetrics & Gynecology and Reproductive Medicine, Peking University First Hospital, Beijing 100034, China
Qi Hongbo
Department of Obstetrics and Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
·
DOI: 10.3760/cma.j.cn113903-20241112-00754
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摘要

胎儿生长受限(fetal growth restriction,FGR)是围产儿患病和死亡的主要原因之一,且可能导致远期不良结局。中华医学会围产医学分会胎儿医学学组、中华医学会妇产科学分会产科学组,以及国家重点研发计划《建立我国胎儿生长曲线和胎儿生长受限干预体系的全链条研究》部分项目骨干基于2019年我国FGR专家共识,结合2019年后多项国际FGR诊治指南,围绕FGR的定义、诊断、临床处理及产后评估,制定了“胎儿生长受限临床诊治标准化表单管理专家共识”,以进一步规范疾病的诊治,推动多中心临床研究的开展,为FGR临床诊治提供有力的循证依据,并为后续相关指南奠定基础。

胎儿生长受限;清单;产前诊断;多数赞同
ABSTRACT

Fetal growth restriction (FGR) is one of the primary causes of morbidity and mortality during the perinatal period and may lead to adverse long-term outcomes. Based on the 2019 expert consensus on FGR in China, and in conjunction with multiple international FGR diagnosis and treatment guidelines published after 2019, Fetal Medicine Subgroup, Society of Perinatal Medicine, Chinese Medical Association, and Obstetrics Subgroup, Society of Obstetrics and Gynecology, Chinese Medical Association, along with core members from the National Key Research and Development Program entitled "Integrated Research on Establishing Fetal Growth Curves and an Intervention System for FGR in China," have formulated an expert consensus on standardized checklists for the clinical diagnosis and treatment of FGR. This consensus focuses on the definition, diagnosis, clinical management, and postnatal assessment of FGR, aiming to further standardize the management promote multicenter clinical research, provide robust evidence-based support for FGR clinical management, and lay the groundwork for subsequent guideline development.

Fetal growth restriction;Checklist;Prenatal diagnosis;Consensus
Sun Luming, Department of Fetal Medicine, Obstetrics and Gynecology Hospital of Tongji University (Sun Luming works at Department of Obstetrics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine), Shanghai 200092, China, Email: mocdef.3ab61nus_gnimul, Tel: 0086-21-20261150
Duan Tao, Department of Obstetrics, Obestetrics and Gynecology Hospital of Tongji University, Shanghai 201204, China, Email: mocdef.oabohaynaudt, Tel: 0086-21-20261234
Yang Huixia, Department of Obstetrics & Gynecology and Reproductive Medicine, Peking University First Hospital, Beijing 100034, China, Email: nc.defudabe.umjbaixiuhgnay, Tel: 0086-10-83573246
Qi Hongbo, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China, Email: mocdef.3ab61827bgnohiq, Tel: 0086-23-89011102

Sun Luming works at Department of Obstetrics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

引用本文

中华医学会围产医学分会胎儿医学学组,中华医学会妇产科学分会产科学组,国家重点研发计划《建立我国胎儿生长曲线和胎儿生长受限干预体系的全链条研究》部分项目骨干. 胎儿生长受限临床诊治标准化表单管理专家共识[J]. 中华围产医学杂志,2025,28(02):89-97.

DOI:10.3760/cma.j.cn113903-20241112-00754

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胎儿生长受限(fetal growth restriction,FGR)是一种常见的妊娠期并发症,可影响多达10%的妊娠,是围产儿患病与死亡的重要原因,与远期不良结局密切相关。FGR定义不明,病因繁多,临床管理复杂。为规范和指导我国FGR的临床诊治工作,2019年中华医学会围产医学分会胎儿医学学组联合中华医学会妇产科分会产科学组,围绕FGR的定义、筛查、预防、诊断、宫内监护及临床处理等相关问题,参考各国FGR指南和已发表的高质量临床研究结果,运用德尔菲法,通过专家意见调查及多学科专家讨论,形成了我国的“FGR专家共识” 1(简称2019年共识)。该共识对我国FGR的临床诊治起到了一定的规范和指导作用,但由于不同医疗机构对FGR的诊治能力及各地卫生经济资源等方面存在差异,导致共识的落地和执行方面存在诸多问题。
为促进FGR临床诊治流程的标准化、规范化,本共识在2019年共识的基础上,参考了国际上2019年后发表的卫生保健体系的循证医学指南,采用表单的模式呈现FGR临床诊治标准化管理路径,指导临床实践,促进多中心临床研究的开展,以期为FGR临床诊治提供强有力的循证证据,为指南的制定奠定基础。本共识参考的国际指南包括“母胎医学会咨询系列#52:胎儿生长受限的诊断和治疗(2020版)” 2、“国际妇产科联盟倡议:胎儿生长受限的筛查、诊断和管理的最佳实践建议(2021版)” 3、加拿大妇产科学会“胎儿生长受限:单胎妊娠的筛查、诊断和管理(2023版)” 4和英国皇家妇产科医师学院“小于胎龄胎儿和生长受限胎儿的调查和管理(2024版)” 5。上述指南均遵循评估、制订和评价(grading of recommendations,assessment,development and evaluation,GRADE)工作组倡导的理念,将证据质量与推荐强度相关联,将推荐意见分为强或弱,或A~D分级推荐。本共识由参与2019年共识制定的部分产科专家、胎儿医学专家、超声专家、临床流行病学专家、新生儿及儿童保健学专家,通过2次线下会议和2次线上会议讨论后形成。
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备注信息
A
孙路明,同济大学附属妇产科医院胎儿医学科(现在上海交通大学医学院附属新华医院产科),上海 200092,Email: mocdef.3ab61nus_gnimul,电话:021-20261150
B
段涛,同济大学附属妇产科医院产科,上海 201204,Email: mocdef.oabohaynaudt,电话:021-20261234
C
杨慧霞,北京大学第一医院妇产生殖医学中心,北京 100034,Email: nc.defudabe.umjbaixiuhgnay,电话:010-83573246
D
漆洪波,重庆医科大学附属第一医院妇产科,重庆 400016,Email: mocdef.3ab61827bgnohiq,电话:023-89011102
E

现在上海交通大学医学院附属新华医院产科

F
中华医学会围产医学分会胎儿医学学组, 中华医学会妇产科学分会产科学组, 国家重点研发计划《建立我国胎儿生长曲线和胎儿生长受限干预体系的全链条研究》部分项目骨干. 胎儿生长受限临床诊治标准化表单管理专家共识[J]. 中华围产医学杂志, 2025, 28(2): 89-97. DOI: 10.3760/cma.j.cn113903-20241112-00754.
G
蔡璐瑶、孙倩倩、陈建平、周鑫垚(同济大学附属妇产科医院),王红坤(上海交通大学附属第一人民医院)
H
所有作者声明无利益冲突
I
国家重点研发计划 (2022YFC2704700)
国家自然科学基金 (82071656)
上海市科学技术委员会课题 (23DZ2303400,21Y11907500)
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