大脑中动脉联合静脉导管预测妊娠期高血压疾病胎儿宫内缺氧的研究

Study on middle cerebral artery and venous duct for predicting fetal intrauterine hypoxia in pregnant women with hypertensive disorders complicating pregnancy

目的探讨大脑中动脉(MCA)联合静脉导管(DV)预测妊娠期高血压疾病胎儿宫内缺氧的应用价值。方法将该院接受诊疗的95例妊娠期高血压孕妇纳入试验组,并取同期95例健康孕妇纳入对照组,比较两组MCA最大血流速度(Vmax)、阻力指标与DV收缩期最大血流速度/舒张期最小血流速度(S/D)、a波情况,并观察两组胎儿出生后Apgar评分、头颅超声表现。结果试验组孕妇孕25~30、31~36、37~41周胎儿MCA Vmax明显高于对照组孕妇(P<0.05),MCA S/D、搏动指数(PI)、阻力指数(RI)均明显低于对照组孕妇(P<0.05);试验组孕妇孕25~30、31~36、37~41周胎儿DV S/D明显高于对照组孕妇(P<0.05);试验组胎儿出生后Apgar评分、MCA RI明显低于对照组胎儿(P<0.05),MCA Vmax明显高于对照组(P<0.05),试验组胎儿出生后窘迫率为33.70%。结论 MCA联合DV预测妊娠期高血压疾病胎儿宫内缺氧具有重要价值,可为孕产妇是否终止妊娠及妊娠结局预测提供重要参考。

Objective To investigate the application value of middle cerebral artery(MCA)combined with ductus venosus(DV)for predicting fetal intrauterine hypoxia in pregnant women with hypertensive disorders complicating pregnancy.Methods Ninety-five pregnant women with hypertensive disorders complicating pregnancy diagnosed and treated in this hospital were included in the experimental group,and 95 healthy pregnant women were included in the control group.The maximal blood flow velocity(Vmax)of MCA,resistance index,maximal systolic blood flow velocity/diastolic blood flow velocity(S/D)of DV and a wave were compared between the two groups.The postnatal Apgar scores and head ultrasonographic findings of the two groups were observed.Results Vmax of fetal MCA in pregnant women with gestational of 25-30 weeks,31-36 weeks and 37-41 weeks of the experimental group was significantly higher than that in pregnant women of the control group(P<0.05),while MCA S/D,PI and RI were significantly lower than those in pregnant women of the control group(P<0.05).The fetal DV S/D in pregnant women with gestational age of 25-30 weeks,31-36 weeks and 37-41 weeks of the experimental group was significantly higher than that in pregnant women of the control group(P<0.05).The fetal postnatal Apgar score and MCA RI in the experimental group were significantly lower than those of the control group(P<0.05),while MCA Vmax was significantly higher than that in the control group(P<0.05).The incidence rate of postnatal fetal distress in the experimental group was 33.70%.Conclusion MCA combined with DV has the great value in predicting fetal intrauterine hypoxia in hypertensive disorders complicating pregnancy,which can provide an important reference for pregnant women to terminate pregnancy and predict pregnancy outcomes.