胎儿静脉导管超声检查在预测宫内生长受限胎儿出生结局中的应用价值

Value of ultrasonography on ductus venosus in predicting neonatal outcome in fetal growth restriction

目的探讨胎儿静脉导管超声检查在预测宫内生长受限胎儿不良出生结局中的应用价值。方法选取我院确诊存在宫内生长受限胎儿的孕妇53例,依据新生儿出生不同结局分为正常组23例、轻微异常组15例和明显异常组15例。检测比较各组胎儿静脉导管多普勒血流参数变化情况。结果胎儿静脉导管的心室收缩期峰值流速/最大心房期回流速度(DVS/A)、静脉导管的阻力指数(DVRI)及静脉导管血流量/脐静脉血流量(QDV/QUV)均可以对FGR胎儿的明显异常出生结局作出预测,其中DVS/A曲线下面积最大,为91%,其次为DVRI,曲线下面积为90%,QDV/QUV曲线下面积为74%。结论 DVS/A、DVRI及QDV/QUV均可以作为预测宫内生长受限胎儿明显异常出生结局的指标,其中DVS/A、DVRI预测价值较高。

Objective To explore the application value of uhrasonograhpy on ductus venosus in predicting neonatal outcome in fetal growth restriction （FGR）. Methods Fifty-three pregnant women with FGR were enrolled and divided into three groups according to neonatal outcome, including normal control （n =23 ）, mild abnormality （n =15） and apparent abnormality groups（n= 15 ）. The Doppler parameters of ductus venosus were measured and analyzed in each group. Results Resistence index （DVm）, ratio of S-peak and A-peak velocity （DV^A）, ratio of ductus venosus blood flow volume and umbilical venous blood flow volume （QDv/Quv） could predict serious neonatal outcome of FGR.The area under receiver operating characteristic curve （AUC） of DV^Awas the biggest （91%）.The second biggest AUC was DVva （90%）.The AUC of Qov/Quvwas 74%. Conclusion DVs^A,DVea and QDv/Quv all can predict serious neonatal outcome of FGR, DVs^A and DVm have high predictive value.