胎儿脑及脐动脉血流检测的临床意义

Clinical significance of fetal cerebral and umbilical arterial blood flow velocity waveforms examination

应用彩色多普勒超声，检测正常妊娠妇女５８例（正常妊娠组），好高征患者３４例（好高征组），好高征合并胎儿生长迟缓（ＩＵＧＲ）５４例（ＩＵＧＲ组）胎儿大脑中动脉及脐动脉血流速波，计算血流的收缩末期峰值（Ｓ）与舒张末期峰值（Ｄ）的比值（Ｓ／Ｄ）、脉搏指数（ＰＩ）、阻力指数（ＲＩ）。结果：好高征组及ＩＵＧＲ组胎儿大脑中动脉血流Ｓ／Ｄ、ＰＩ、ＲＩ值变化趋势与正常妊娠组相同，随妊娠进展逐渐下降，当Ｓ／Ｄ＜４、ＰＩ＜１．６、ＲＩ＜０．６时，表明胎儿缺氧。好高征组及ＩＵＧＲ组脐动脉血流各指标随妊娠进展逐渐上升，当Ｓ／Ｄ＞３、ＰＩ＞１．７、ＲＩ＞０．７时，胎儿缺氧、胎儿窘迫和ＩＵＧＲ的发生率增加，围产儿异常结局占４８％。提示：对胎儿大脑中动脉及脐动脉血流进行检测，可监护胎儿宫内状况，并对妊娠结局有预测价值。

olor boppler was used to examine the blood flow velocity waveforms of fetal middle cerebral artery (MCA) and umbilical artery (UA) in normal pregnancy(58 cases),pregnancy induced hyper-tension (PIH)with fetal growth retardation (IUGR)(54 cases)and without IUGR (34 cases).The peak-systolic/diastolic ratio (S/D),pulse index(PI)and resistance index (RI)values of MCA and UA were calculated.The results showed that values of MCA in cases of PIH decreased with advance of gestational age same as in normal group. If S/D was<4, PI<1.6, and RI<0.6,the fetus would be hypoxia. The values of UA in patients with PIH increased with advance of gestational age,in con-trast to normal prepency. When S/D>3, PI>1.7,and RI>0.7, the fetus was at risk of hypoxia and distress and the incidence of IUGR would increased with an outcome of 48%fetal abnormality.When S/D, PI, RI values of UA increased significantly while waveforms decreased and absent or re-verse blood flow in end-diastolic were present,the fetus would be in severe hypoxia or abnormal de-velopment, and a poor outcome,which should be treated immediately to lower perinatal mortality.This study showed that examination of fetal blood flow velocitv wavefoums in MCA and UA is a valuable method of fetal monitoring and useful in predicting fetal prognosis.