摘要
目的:探讨产前超声胎儿脐动脉(UA)、大脑中动脉(MCA)及孕妇子宫动脉(UtA)血流动力学指标与羊水过少胎儿结局关系及预测价值。方法:选取2018年1月-2020年1月于本院产前检查羊水过少孕妇200例为羊水过少组,同期正常孕妇200例为对照组。彩色多普勒超声检测UA、MCA、UtA的阻力指数(RI)、搏动指数(PI)、收缩期峰值流速与舒张末期血流速度的比值(S/D);比较妊娠结局,分析UA、MCA、UtA对羊水过少胎儿结局的预测价值。结果:羊水过少组UA-RI、UA-PI、UA-S/D、UtA-RI、UtA-PI、UtA-S/D水平及胎儿宫内生长受限(IUGR)、胎儿窘迫、新生儿窒息、新生儿畸形发生率均高于对照组,MCA-RI、MCA-PI、MCA-S/D水平低于对照组(均P<0.05);妊娠不良组UA-RI、UA-PI、UA-S/D、UtA-RI、UtA-PI、UtA-S/D水平高于妊娠良好组,MCA-RI、MCA-PI、MCA-S/D水平低于妊娠良好组(均P<0.05)。UA-RI、UA-PI、UA-S/D、MCA-RI、MCA-PI、MCA-S/D、UtA-RI、UtA-PI、UtA-S/D预测羊水过少胎儿结局的曲线下面积(AUC)分别为0.837、0.830、0.860、0.826、0.855、0.878、0.856、0.848、0.861。结论:羊水过少孕妇UtA及胎儿UA的RI、PI、S/D水平升高,胎儿MCA的RI、PI、S/D水平降低,且与妊娠结局关系密切,产前超声监测UA、MCA、UtA有助于预测羊水过少胎儿结局。
Objective:To investigate the correlation between the hemodynamic indexes examined by prenatal ultrasound of the fetal umbilical artery(UA)and middle cerebral artery(MCA),and uterine artery(UtA)of women with oligohydramnios and their fetal outcomes.Methods:200 pregnant women with oligohydramnios were selected in study group from January 2018 to January 2020,and 200 normal pregnant women were included in control group during the same period.The resistance index(RI),pulsatility index(PI),the ratio peak systolic velocity to end-diastolic blood flow velocity(S/D)of fetal UA and MCA,and UtA of the women were detected by color Doppler ultrasound.The pregnancy outcomes of the women were compared between the two groups.In the study group,the values of the blood flow parameters,such as fetal UA and MCA,and maternal UtA for predicting fetal outcomes were analyzed.Results:The values of RI,PI,and S/D of UA,PI and S/D of UTA,and the incidences of intrauterine growth restriction(IUGR),fetal distress,neonatal asphyxia and neonatal malformation in the study group were significant higher than those in the control group.The values of PI,RI,and S/D of MCA in the study group were significant lower than those in the control group(all P<0.05).The values of RI,PI,and S/D of UA,RI,PI,and S/D of UTA of the women with adverse pregnancy were significant higher than those of the women with normal pregnancy,but the values of RI,PI,and S/D of MCA of the women with adverse pregnancy were significant higher than those of the women with normal pregnancy(all P<0.05).The area under the curve(AUC)of the values of RI,PI,S/D of UA,and RI,PI,and S/D of UTA,and RI,PI,S/D of MCA for predicting fetal outcomes of the women with oligohydramnios were 0.837,0.830,0.860,0.826,0.855,0.878,0.856,0.848,and 0.861,respectively.Conclusion:The values of RI,PI,and S/D of maternal UtA and fetal UA of the pregnant woman with oligohydramnios have increased,but the values of RI,PI,and S/D of fetal MCA have decreased,which all are closely related to pregnancy outcomes.Prenatal ultrasound monitoring hemodynamic parameters of fetal UA and MCA,and maternal UtA can help predict the fetal outcomes of the pregnant women with oligohydramnios.
作者
姚燕婷
陈燕
宋勤
何丽君
YAO Yanting;CAEN Yan;SONG Qin;HE Lijun(The Third People's Hospital of Hangzhou, Zhejiang Province, 310016)
出处
《中国计划生育学杂志》
2021年第8期1731-1735,共5页
Chinese Journal of Family Planning
基金
杭州市科技发展计划项目(20180533B62)。
关键词
产前超声
羊水过少
子宫动脉血流参数
脐动脉
大脑中动脉
胎儿结局
预测
Prenatal ultrasound
Oligohydramnios
Uterine artery hemodynamic parameters
Umbilical artery
Middle cerebral artery
Fetal outcome
Prediction
