胎儿脐血流监测在高危妊娠中的预测作用

Predictive role of the monitoring of fetal cord blood flow in high risk pregnancies

目的:探讨胎儿脐血流监测在高危妊娠中的预测作用。方法:以400例单胎妊娠孕妇为研究对象,分为高危妊娠组和正常妊娠组,各200例,应用彩色多普勒超声对胎儿的脐动脉和母体子宫螺旋动脉的血流进行测定。结果:高危妊娠组胎儿脐血流和子宫血流S/D比值均高于正常妊娠组(P<0.05);脐血流S/D≥3.0的孕妇羊水污染、Apgar评分≤7分、低体重、新生儿预后不良及剖宫产发生率均高于S/D<3.0的孕妇(P<0.05);子宫血流S/D≥2.6的孕妇羊水污染、Apgar评分≤7分、低体重、新生儿预后不良及剖宫产发生率均高于S/D<2.6孕妇(P<0.05);胎儿脐血流、子宫血流联合测定预测新生儿预后不良的阳性率为75.00%,明显高于单项检查预测值(P<0.05)。结论:妊娠晚期彩色多普勒超声监测胎儿脐血流、子宫血流状态可作为脐血流预测不良妊娠结局的补充。

Objective： To discuss the predictive role of the monitoring of fetal cord blood flow in high risk pregnancies. Methods： Four hundred singleton late pregnancies were enrolled and divided a high risk pregnancy group and a normal pregnancy group with 200 cases each. The blood flow in the umbilical artery and the uterine spiral artery of the fetus was determined by color Doppler ultrasound. Results： The S/D ratio of umbilical cord blood flow and uterine blood flow was higher in the high-risk pregnancy group than normal pregnancy group（P〈0.05）. The incidence of amniotic fluid pollution, Apgar score ≤ seven points, low weight, poor neonatal prognosis and cesarean section rate was higher in the pregnancy with S/D≥3.0 than S/D3.0（P〈0.05）. The positive rate of poor neonatal prognosis measured by fetal umbilical cord blood stream combined with uterine blood flow was 75.00%, which was significantly higher than that of the single check forecast（P〈0.05）. Conclusion： The blood flow in fetal umbilical artery and spiral artery measured by color Doppler ultrasound in the late pregnancies can be used as a supplement for umbilical blood flow to predict adverse pregnancy outcome.