脐动脉血流监测结合无应激试验预测胎儿窘迫的临床观察

Detection of umbilical artery blood flow combined with non-stress test for prediction of fetal distress

目的:探讨脐动脉血流监测结合无应激试验(NST)预测胎儿窘迫的临床价值。方法:378名孕36+2～42+3周妇女于入院后临产前测脐动脉收缩期最高血流速度(S)和舒张期最低血流速度(D)的比值(S/D值),并分为两组,观察S/D值与NST结果、胎儿窘迫的关系,以及新生儿出生情况及预后。结果:A组(S/D≥3.0)与B组(S/D<3.0)NST无反应型比例有差异(P<0.05),羊水污染、新生儿窒息、低体重儿的发生率均有差异(均P<0.05)。A组中NST有反应型的新生儿结局较无反应型良好。S/D值预测新生儿结局的假阳性率高于NST结果,其特异性、敏感度低于后者(均P>0.05)。两者联合后,预测结果的假阳性率降低(P<0.01),特异度和敏感度提高(均P<0.05)。结论:脐血流监测结合NST简便易行,可用于临产前预测胎儿窘迫。

Objective ： To evaluate the clinical value of detection of umbilical artery blood flow combined with non - stress test for prediction of fetal distress. Methods ： A total of 378 women with gestational ages between 36^ ＋2 and 42^ ＋3 weeks were recrui- ted. Detection of umbilical artery blood flow and non - stress test were conducted. Women were divided into two groups ac- cording to the result of umbilical artery blood flow detection. And the incidence of fetal distress and the outcome of newborns were evaluated. Results ： There was a significant difference in the incidence of non reaction pattern between group A （ S/D ≥ 3.0） and group B （ S/D 〈 3.0）. And there were significant differences in incidences of meconium stained amniotic fluid, as- phyxia neonatorum and low birth weight （ P all 〈 0.05 ）. The outcome of newborns with reaction pattern was better than those with non reaction pattern in group A. The false positive rate of the result of umbilical artery blood flow detection was higher than that of non - stress tset for prediction of fetal distress, while the specificity and sensitivity were lower. The false positive rate reduced when using results of umbilical artery blood flow detection combined with non - stress test （ P 〈 0.01 ）, while both the specificity and sensitivity increased （ P all 〈 0.05 ）. Conclusion ： Detection of umbilical artery blood flow combined with non - stress test could be used for prediction of fetal distress.