三维超声诊断胎儿宫内窘迫的临床价值

Clinical value of three-dimensional ultrasound diagosis in fetal distress

目的探讨三维(3D)超声检测胎儿宫内窘迫(IFD)的临床价值。方法用GElog9三维超声诊断仪对48例单胎孕妇分别进行二维多普勒超声检查(2D)和三维超声图像重建,通过观察胎心率,脐动脉收缩期峰值和舒张末期流速之比(S/D),羊水,胎动等指标做出超声诊断。结果胎心率、胎动异常是判断胎儿有无缺氧和缺氧程度的主要指标;脐带、羊水异常是造成胎儿宫内窘迫的原因。重建的胎儿脐带血管解剖结构清晰,螺旋层次分明,脐带绕颈及周数一目了然,与2D超声相比较有较高的特异性和敏感性。结论 3D超声能直接形象和层次分明的显示脐带血管解剖形态、空间转向,诊断胎儿宫内窘迫的符合率100%,明显高于2D。为临床提供重要参考依据,对提高胎儿质量、预防和降低围产期胎儿死亡率具有重要的临床意义。

Objective To investigate the clinical value of three-dimensional（3D）ultrasound detection for fetal distress（IFD）.Methods Forty-eight cases of pregnant women with singleton pregnancies were examined with GE logiq 9 three-dimensional ultrasound diagnostic apparatus.2D and 3D ultrasound images were reconstructed,the ultrasound diagnosis was made according to the observation of fetal heart rate,umbilical cord blood flow S/D value,amniotic fluid,fetal movement and other indicators.Results The fetal heart rate and abnormal fetal movement were key indicators for determining fetal hypoxia and hypoxia levels.The umbilical cord and amniotic fluid abnormalities were caused by fetal distress.Compared with 2D ultrasound,the reconstructed fetal umbilical cord blood vessel was anatomical clear and spiral structured.Umbilical cord entanglement could be observed easily in 3D ultrasound.Conclusion 3D ultrasound can directly display the anatomic structure image of umbilical vessels and space shift,the coincidence rate for fetal distress diagnosis is 100%,significantly higher than 2D.3D ultrasound examination provides an important reference for clinical diagnosis and shows clinical significance for improving the quality of fetus and reduction of perinatal fetal mortality.