脐动脉血流速波、产前胎心监护及脐动脉血气分析与新生儿结局的对比研究

Comparative Study of Umbilical Artery Doppler Velocimetry,Antenatal Fetal Heart Rate Monitoring and Umbilical Artery Blood-Gas Analysis in the Prediction of Neonatal Outcome

测定１１５例足月妊娠者（正常妊娠６２例，高危妊娠５３例）脐动脉血流速波（ＵｍＡＳ／Ｄ），同时作产前胎心电子监护（ＮＳＴ），其中３７例于分娩时抽取脐动脉血作血气分析。对上述三种方法预测新生儿结局的效果进行比较。结果表明：ＵｍＡＳ／Ｄ、脐动脉血的ｐＨ值较ＮＳＴ对新生儿结局不良有较好的预测性，异常ＵｒｎＡＳ／Ｄ与新生儿酸中毒有密切关系。

One hundred and fifteen term preg-nancies(62 normal pregnancies, 53 high risk pregnan-cies)were observed by umbilical artery hoppler ve-Iocimetry(UmAS /D ratio)and antenatal fetal heartrate monitoring(NST), and 37 of them were also ob-served by umbilical artery blood-gas analysis at birth.We cornpared the effects of these three rnethods topredict the neonatal outcome.The standards of theneonatal poor outcome were 5-min Apgar score≤7and/or a birth weight<2500g(SGA ).The resultswere:(1)The neonatal poor outcome were more fre-quently observed in the abnormal UmAS/D ratio(≥3.0)group and in the UmA pH≤7.2 group(P<0.005,P<0. 025,respectively),but there was no sig-nificant difference between the NST reactive or non-reactive groups(P>0. 05 );(2)The neonatal acidosisat birth was also associated with the abnormal UmAS/Dratio(≥3.0);(3)The sensitivities ofUmAS/Dratio, UmA pH, NST to predict the 5-min Apgarscore≤7were 60.0%,60.O%,20.0%respectively;the specificities 84.6%, 81.3%, 81.8%respectively.And their sensitivies to predict SGA were 100.0%,100.0%, 40.0%respectively ;the specificoities86.4/,80.0/,82.7%respectively. Our data showthat UmA S/Dratio and UmA pH are better thanNST in the prediction of neonatal outcorne,and the ab-normal UmAS/Dratio is closely associated withneonatal acidosis at birth.