妊娠期高血压疾病孕妇胎儿脐动脉、肾动脉、大脑中动脉及静脉导管多普勒血流监测的临床价值

Clinical value of Doppler blood flow monitoring of fetal umbilical artery,renal artery,medial cerebral artery,and ductus venosus in pregnant women with hypertensive disorder complicating pregnancy

目的探讨妊娠期高血压疾病孕妇胎儿脐动脉、肾动脉、大脑中动脉及静脉导管多普勒血流动力学变化及临床意义。方法选取2014年1-12月于该院就诊的妊娠晚期妊娠期高血压疾病孕妇100例作为妊娠期高血压疾病组,选取同期正常健康孕妇98例作为对照组。于分娩前一周内行彩色多普勒超声检测胎儿脐动脉(UA)、肾动脉(RA)、大脑中动脉(MCA)、静脉导管(DV)的搏动指数(PI)及收缩期峰值血流速度与舒张末期血流速度的比值S/D。比较两组胎儿血液动力指标变化,新生儿出生后1min及5min的Apgar评分及出生体重。结果妊娠期高血压疾病组胎儿UA、RA及DV阻力指标明显高于对照组胎儿。妊娠期高血压疾病组胎儿生长发育受限,普遍存在缺氧,与对照组比较差异有统计学意义(P<0.05)。结论彩色多普勒超声检测能观察娠期高血压疾病孕妇胎儿的脐肾动脉及静脉导管血流变化,对预测妊娠期高血压疾病胎儿宫内状态具有一定的临床应用价值。

Objective To explore the hemodynamic changes of fetal umbilical artery （UA）, renal artery （RA）, medial cerebral artery （MCA）, and duetus venosus （DV） and clinical significance in pregnant women with hypertensive disorder complicating pregnancy （HDCP）. Methods A total of 100 pregnant women with HDCP during the third trimester of pregnancy who registered in the hospital from January to December in 2014 were enrolled as HDCP group, and 98 healthy pregnant women during the same period were selected as control group. At a week before delivery, color Doppler ultrasound was used to examine pulsatility index （PI） and the ratio of peak systolic blood flow velocity to end diastolic blood flow velocity （S/D） of fetal UA, RA, MCA and DV. The changes of hymodynamic parameters, Apgar score at the first minute and the fifth minute after birth, and birth weight were compared between the two groups. Results In HDCP Group, the resistance indexes of fetal UA, RA, and DV were significantly higher than those in control group （ P〈0. 05 ） . Growth restriction and hy- poxia were common in HDCP group, which had statistically significant difference compared with control group （ P〈0. 05 ） . Conclusion Color Doppler ultrasound can be used to observe hymodynamie changes of fetal UA, RA, and DV in pregnant women with HDCP, and it has certain clinical value to predict intrauterine state of fetuses.