胎儿脐血流S/D值在临床的应用价值

Clinical value of the S/D ratio in umbilical blood flow for fetus

目的 总结胎儿脐血流S/D值异常在胎儿宫内发育迟缓、妊高征、脐带缠绕、胆汁瘀积症等病理情况时胎儿及新生儿的结局。方法 采用SRF6 0 8型胎儿脐血流检测仪对 387例孕妇共进行 40 0次脐血流检查 ,以求得脐动脉血流收缩期末峰值、舒张期末峰值之比值 (S/D) ,超出正常妊娠各孕周S/D值第 90百分位即S/D≥ 90th %者为异常。结果 脐血流波形S/D≥ 90th %的 33例孕妇中发生胎儿窘迫 2 3例 ,剖宫产 17例 ,与S/D <90th %组相比其发生率均明显上升 ,差异非常显著 (P <0 .0 1) ,且IUGR和妊高征孕妇中S/D≥ 90th %所占比例较高分别为42 .9%和 16 .7%。结论 脐血流S/D值≥ 90th %比 <90th %更易在产程中发生胎儿宫内窘迫 ,且剖产率也显著提高 ,此值可作为一种判断脐血流阻抗的新指标。

Objectives To summarize the influence of abnormal S/D ratio for fetus and infants in the cases of intrauterine growth retardation(IUGR),hypertension of pregnancy,umbilical twine and cholestasis.Methods Umbilical blood flow of 387 pregnancy women(400 times) was tested and seek the systolic/diastolic peak value,(eg.S/D ratio) in umbilical arterial blood flow.The abnormal is considered when the S/D ≥90th% contrasted the normal pregnancy women.Results Among the 33 pregnancy women whose S/D ratio ≥90th%,fetal distress appeared in 23 cases and 17 women must be performed abdominal delivery.The incidence is higher obviously than the pregnancy women whose S/D <90th% (P<0.01).There were 42.2% cases with IUGR and 16.7% women with hypertension of pregnancy in S/D ≥90th% cases.Conclusions High incidence of fetal distress and abdominal delivery happened in the women whose S/D ≥90th%,and S/D ratio in umbilical blood flow is a very important new index used to judge the fetal prognosis.