胎儿脐动脉血流速度与妊娠结局的关系

Relationship of fetal umbilical artery blood stream and the outcome of pregnancy

目的应用彩色多普勒超声检测脐动脉血流S/D比值,探讨S/D比值增高的病因及其与妊娠结局的关系。方法 157例脐动脉血流S/D比值增高的孕妇作为观察组,同期120例S/D比值正常的孕妇作为对照组,分析S/D比值增高的病因并比较两组的妊娠结局。结果①观察组妊娠期高血压疾病60例,脐带绕颈30例,妊娠期肝内胆汁淤积症18例,羊水过少17例,糖尿病13例,过期妊娠11例,双胎8例,前置胎盘5例,胎儿畸形5例;②观察组的胎儿窘迫、新生儿窒息、低体重儿、新生儿畸形及围产儿死亡明显高于对照组(P<0.05);③脐动脉舒张末期血流缺失共9例,其中3例合并子痫前期重度,2例胎儿生长受限,2例双胎输血综合征,染色体异常1例,围产儿死亡7例。结论多种产科并发症、合并症及胎儿畸形可致脐动脉血流S/D比值增高,脐动脉血流异常与不良妊娠结局相关。存在高危因素时,胎儿脐动脉血流监测对预测不良妊娠结局有较高的实用价值,孕期加强监测,适时终止妊娠,有助于改善母婴预后。

Objective Application of detection of fetal umbilical artery blood stream by ultrasound test was measured the main reason of increased fetal umbilical artery blood stream S/D ratio, and the relationship between the increased fetal umbilical artery blood stream S/D ratio and the outcome of pregnancy. Methods 157 eases with increased S/D ratio were selected as cases and 120 cases with common S/D ratio were selected as controls, the reason of increased S/D ratio and compared the two pregnant outcome in the two groups was analyzed. Results （1） Among 157 cases with increased S/D ratio, 60 cases were due to hypertension syndrome of pregnancy, 30 cases were cord around neck, 18 cases were intrahepatic cholestasis of pregnancy （ICP）, 17 cases were oligohydramnios, 13 cases were diabetes, 11 eases were postponed pregnancy, 8 eases were twin pregnancy, 5 cases were placenta previa and 5 eases were fetal anomaly ; （2） The results indicated that incidence of the fetal distress, neonatal asphyxia, low birth weight infant, fetal abnormalities and perinatal infant mortality of cases was significantly higher than controls （P 〈 0. 05） ; （3） 9 cases were absent end - diastolic flow velocity （ AEDV）, and 3 cases combine with the severe preeelampsia. 2 cases were FGR, 2 cases were twin transfusion syndrome, 1 case was chromosomal abnormali- ty, 7 cases were perinatal death. Conclusion Many complications and fetal abnormalities should cause the increase of S/D ratio. The fetal umbilical artery blood stream abnormality correlate with poor pregnant prognosis. To monitor the change of S/D has high value in predicting the pregnant abnormalities, and to enhance the detection during pregnancy and terminating pregnancy properly could improve the prognosis of mother and child for high risk factors existed.