晚孕期脐带绕颈胎儿大脑中动脉与脐动脉的阻力指标研究

Research of the middle cerebral and umbilical artery resistance indexes in fetuses with umbilical cord around the neck in late stage of pregnancy

目的:通过检测妊娠晚期脐带绕颈胎儿大脑中动脉(MCA)及脐动脉(UA)的阻力指标,寻找脐带绕颈胎儿宫内缺氧的依据。方法:用彩色多普勒超声对70例正常晚期妊娠胎儿和65例脐带绕颈胎儿MCA、UA的阻力指标进行分析。结果:正常组与绕颈1周组阻力指标比较无明显差异(P>0.05);与绕颈2周及以上组比较有非常显著性差异(P<0.01)。绕颈1周组与绕颈2周及以上组比较也有显著性差异(P<0.05)。结论:妊娠晚期脐带绕颈引起的胎儿宫内缺氧主要是脑缺氧,表现在UA阻力指标增高,MCA的阻力指标降低,在胎儿窘迫发生前作出诊断,具有重要的临床价值。

Objective： To investigate the evidence of fetal hypoxia in fetuses with umbilical cord around the neck through the test of the middle cerebral artery（MCA） and umbilical artery（UA） resistance indexes.Methods： MCA and UA resistance indexes of 70 normal fetuses（normal group） in late pregnancy and 65 fetuses with umbilical cord around the neck（around the neck group） were measured and analyzed by color Doppler ultrasonography.Results： No significant difference was found between the normal group and around the neck（one round） group in the resistance indexes（P0.05）,but significant differences were found between normal group and around the neck（two rounds or more） group（P0.01）.and between the one round and two rounds or more around the neck group（P0.05）.Conclusion： The fetal hypoxia in fetuses with umbilical cord around the neck in late pregnancy is mainly reflected as cerebral anoxia,with the symptoms of increasing the umbilical artery resistance index and decreasing the middle cerebral artery resistance index.This study may provide some clinical values in early diagnosis of fetal hypoxia before fetal distresses.