重度子痫前期患者胎儿脐动脉血流的变化与围生儿预后关系分析

The changes of fetal umbilical artery blood flow and the analysis of perinatal prognosis in severe preeclampsia

目的探讨重度子痫前期患者胎儿脐动脉血流的变化及围生儿预后。方法回顾性分析我院2016年12月至2017年12月重度子痫前期患者59例,并选择该段时间没有子痫前期的妇女51例作为对照组,应用彩色多普勒超声技术测量脐动脉血流,多普勒参数包括脐动脉收缩末期最大流速和舒张末期最大流速之比(即S/D比值)、阻力指数(RI)和搏动指数(PI),分娩后记录各组新生儿1min Apgar评分、体重及围生儿预后。结果重度子痫前期组胎儿脐动脉S/D比值、RI、PI均高于对照组,且新生儿1min Apgar评分及出生体重均小于对照组,差异有统计学意义(P<0.05),重度子痫前期围生儿死亡的发生率增高。结论重度子痫前期患者脐血流参数有明显的变化,可以作为判断胎儿宫内状况的指标,彩色多普勒超声技术为重度子痫前期患者临床上选择分娩时机及围生儿预后提供了简便无创的监测手段。

Objective To explore the umbilical blood flow changes and the perinatal outcome among women with severe preeclampsia. Methods This retrospective study was conducted from December 2016 to December 2017 and included 59 severe preeclampsia patients,and 51 subjects without preeclampsia were enrolled as control group. Parameters of umbilical arterial blood flow including S/D ratio,resistance index（RI）,pulsatility index（PI）. Apgar score,birth weight and the perinatal outcomes were recorded. Results The values of these parameters（including S/D ratio,RI,PI） were significantly higher in patients with severe preeclampsia than in the control group. Apgar score and the birth weight of the newborns were significantly lower（P〈0.05） than the control group. The incidence of perinatal death of severe preeclampsia was increased. Conclusion The parameters of umbilical cord blood flow in patients with severe preeclampsia have obvious changed,which can be used as an indicator of fetal intrauterine status. Color doppler ultrasonography provides a simple and noninvasive method for monitoring the delivery and the perinatal outcome in patients with severe preeclampsia.