妊娠期糖尿病孕妇胎儿脐动脉频谱血流收缩期最大血流速度与舒张期血流速度比值对胎儿宫内窘迫的预测价值

The predictive value of the ratio of peak systolic velocity to diastolic flow velocity of umbilical artery blood of pregnant women with gestational diabetes and fetal distress in uterus

目的:探讨妊娠期糖尿病孕妇胎儿脐动脉频谱血流收缩期最大血流速度与舒张期血流速度比值(S/D值)对胎儿宫内窘迫预测价值。方法:选取150例孕妇,其中73例为妊娠期糖尿病孕妇(糖尿病组)和77例健康孕妇(对照组)。通过彩超确定38孕周时胎儿脐动脉频谱S/D值,并对比两组胎儿脐动脉频谱S/D的均值和变化情况及其对胎儿宫内窘迫的预测价值。结果:糖尿病组胎儿脐动脉频谱S/D值明显比对照组高(P<0.05)。两组不同胎儿脐动脉频谱比值区间胎儿宫内窘迫率存在统计学差异(P<0.05)。两组不同脐动脉频谱比值区间胎儿宫内窘迫率均明显相关(P<0.05)。结论:妊娠期糖尿病孕妇胎儿脐动脉频谱S/D值和其胎儿宫内窘迫率均明显比非妊娠期糖尿病孕妇高,可以采用测定妊娠期糖尿病孕妇胎儿脐动脉频谱S/D值,预测胎儿宫内窘迫。

Ob je c t iv e ：To in v e s tig a te th e p redictive value of th e ra tio of p eak sys to lic velocity to diastolic flow velocity of umbilical artery blood of pregnant women with gestational diabetes and fetal distress in uterus. Methods： 150 cases clinical data of pregnant women, including 73 cases of pregnant women with gestational diabetes mellitus （the diabetes group） and 77 healthy pregnant women （the non-diabetic group）. Mean value of S/D value of umbilical artery blood of fetuses at gestational age of 38 weeks was measured by color Doppler ultrasound. Besides,analysis of the predictive value between changes in S/D value and fetal distress in uterus was determined. Results ： Mean value of S/D value of umbilical artery blood in diabetes group was significantly higher than that in non-diabetic group （P〈0 . 05）. Statistically significant differences were showed in the incidence rate of fetal distress in uterus between fetuses of different ranges of S/D value of umbilical artery blood in both groups （P〈0 . 0 5 ） . T h e re was a s ignif icant co r re la -tion between S/D value of umbilical artery blood and the incidence of fetal distress in both groups （P〈0. 0 5 ） . C on -clusion： S/D value of umbilical ar tery blood and incidence of rate of fetal dis t res s in uterus in pregnant women wi th gestational diabetes are significantly higher than those of pregnant women without gestational diabetes. Fetal distress can be predicted and controlled at early stage by measuring S/D value of umbilical artery blood in pregnant women with gestational diabetes.