多普勒超声检测大脑中动脉收缩期峰值流速与胎儿贫血

Doppler ultrasonography in detection of middle cerebral artery peak systolic velocity for the diagnosis of fetal anemia

目的采用多普勒超声测量胎儿大脑中动脉收缩期峰值流速(MCA-PSV),并探讨其与胎儿贫血的关系。方法检测535名孕14～40周正常胎儿的MCA-PSV,建立标准值。以MCA-PSV>相同孕周均数+2个标准差或1.5×相同孕周均数为标准,对MCA-PSV异常增高的胎儿进行评价。结果胎儿MCA-PSV与孕周呈线性正相关,线性回归方程为:MCA-PSV=-9.955+1.561×孕周。以不同孕周胎儿MCA-PSV均数+2个标准差作为筛查胎儿贫血标准,在209例针对性产科超声检查中共筛查出7例,其中4例MCA-PSV>相同孕周正常胎儿均数的1.5倍,经引产证实为严重胎儿贫血。结论胎儿MCA-PSV高于1.5倍相同孕周均数可作为产前超声筛查胎儿贫血的一个重要提示指标。

Objective To detect the normal value of the fetal middle cerebral artery peak systolic velocity （MCA-PSV） with Doppler ultrasonography, and to investigate the association between MCA-PSV and fetal anemia. Methods Doppler ultrasonography was performed in 535 normal pregnant women from the 14th to the 40th week of gestation. MCA-PSV was measured, and the standard value of the normal fetal MCA-PSV was established. Fetuses with abnormal high MCA-PSV were assessed with a standard of MCA-PSV〉mean vale of gestational weeks＋2 standard deviation or 1.5 multiples of mean value of gestational weeks. Results The value of normal fetal MCA-PSV correlated well with the gestational weeks （linear regression equation was,, MCA-PSV= - 9. 955＋1. 561×weeks; r=0. 795, P〈0. 0001）. Using 1.5 multiples of the mean of different gestational weeks to diagnose the moderate and severe fetal anemia, 7 fetuses were screened out of 209 of obstetric ultrasonography; 4 of them had MCA-PSV〉1. 5 multiples of mean value of gestational weeks and were proved with induced labor. Conclusion The value of 1.5 multiples of mean value of gestational weeks of fetal MCA-PSV in prenatal ultrasonography might be an important clue for the diagnosis of fetal anemia.