胎儿脐动脉、肾动脉及大脑中动脉血流动力学预测晚孕期妊娠糖尿病妊娠结局的临床价值

Clinical Value of Fetal Umbilical Artery,Renal Artery and Middle Cerebral Arterial Hemodynamics in Predicting Pregnancy Outcome of Gestational Diabetes Mellitus during Late Pregnancy

目的:探讨晚孕期单胎妊娠糖尿病患者行胎儿脐动脉、肾动脉、大脑中动脉血流动力学检测对妊娠结局的影响。方法:选取2015年1月-2017年7月于本院就诊的116例晚孕期单胎妊娠糖尿病患者为研究对象,并设为研究组,同期选择116例健康单胎孕妇为对照组。应用彩色多普勒超声对两组孕妇检测,观察比较胎儿脐动脉、肾动脉、大脑中动脉血流动力学情况。结果:研究组胎儿脐动脉、肾动脉的搏动指数(PI)、血流比值(S/D)及阻力指数(RI)均明显高于对照组,差异均有统计学意义(P<0.05);研究组胎儿大脑中动脉PI、S/D及RI均明显低于对照组,差异均有统计学意义(P<0.05)。研究组胎儿窘迫发生率为6.90%(8/116),明显高于对照组的0.86%(1/116),差异有统计学意义(X^2=11.329,P<0.05)。结论:对晚孕期单胎妊娠糖尿病患者行胎儿脐动脉、肾动脉、大脑中动脉血流动力学检测,能够及时发现胎儿缺氧情况,改善妊娠结局,临床具有推广价值。

Objective：To investigate the effect of fetal umbilical artery,renal artery and middle cerebral arterial hemodynamic examination on pregnancy outcome of single gestational diabetes mellitus during late pregnancy.Method：A total of 116 patients with single gestational diabetes mellitus during late pregnancy treated in our hospital from January 2015 to July 2017 were selected as the study objects,they were set up as the study group.In the same period,116 healthy single pregnant women were selected as the control group.Two groups of pregnant women were examined by color doppler ultrasonography,the hemodynamic condition of fetal umbilical artery,renal artery and middle cerebral artery were observed and compared.Result：The pulsation index（PI）,the blood flow ratio（S/D） and the resistance index（RI） of the fetal umbilical artery and renal artery in the study group were significantly higher than those in the control group,the differences were statistically significant（P〈0.05）;the PI,S/D and RI of the fetal middle cerebral artery in the study group were significantly lower than those in the control group,the differences were statistically significant（P〈0.05）.The incidence of fetal distress in the study group was 6.90%（8/116）,which was significantly higher than 0.86%（1/116） in the control group,the difference was statistically significant（χ^2=11.329,P〈0.05）.Conclusion：The hemodynamic examination of fetal umbilical artery,renal artery and middle cerebral artery in patients with single gestational diabetes mellitus during late pregnancy can detect fetal hypoxia condition in time,improve the pregnancy outcome,the clinical practice is worth popularizing.