脐动脉血流S/D值测定结合胎心监护在诊断胎儿宫内窘迫中的价值分析

Value of S/D value measurement of umbilical artery blood flow combined with fetal heart monitoring in diagnosis of fetal distress

目的探讨脐动脉血流收缩期峰值流速/舒张末期流速(S/D)值测定结合胎心监护在诊断胎儿宫内窘迫中的应用价值。方法回顾性分析2017年1月~2018年11月于我院住院分娩的60例孕妇的临床资料,均经脐动脉血流S/D值测定及胎心监护,根据检测结果分为两者均异常组(13例)、S/D值异常组(9例)、胎心监护异常组(6例)、均正常组(32例)。比较四组胎儿宫内窘迫发生率及妊娠结局情况;与临床病理结果比较,分析脐动脉血流S/D值测定结合胎心监护对胎儿宫内窘迫的诊断价值。结果四组间胎儿宫内窘迫、羊水污染、剖宫产及新生儿窒息的发生率有明显差异,其中脐动脉血流S/D值及胎心监护均异常组上述指标的发生率均明显高于另外三组(均P<0.05)。脐动脉血流S/D值联合胎心监护诊断胎儿宫内窘迫的灵敏度、特异度和准确性均高于单一的脐动脉血流S/D值测定和胎心监护。结论脐动脉血流S/D值测定结合胎心监护对胎儿宫内窘迫具有较高的诊断价值,对防止不良妊娠结局、改善围产儿预后均有重要意义。

Objective To explore the application value of the umbilical artery blood flow systolic peak flow velocity/ end diastolic velocity(S/D) rate combined with fetal heart monitoring in the diagnosis of fetal distress. Methods The clinical data of 60 pregnant women who were hospitalized and delivered in our hospital from January 2017 to November 2018 were retrospectively analyzed.All pregnant women were measured by S/D value of umbilical arterial blood flow and fetal heart monitoring.According to the test results,they were divided into four groups:the abnormal group (13 cases),the S/D abnormal group (9 cases),the fetal heart monitoring abnormal group (6 cases) and the normal group (32 cases).The incidence of intrauterine distress and pregnancy outcomes were compared between the four groups. Compared with clinical pathology results,the diagnostic value of S/D value measurement of umbilical arterial blood flow combined with fetal heart monitoring for fetal distress were analyzed. Results There were significant differences in the incidence of intrauterine distress,amniotic fluid contamination, cesarean section and neonatal asphyxia among the four groups,and the incidence of the above indicators in the abnormal group were significantly higher than those of the other three groups(P < 0.05).The sensitivity, specificity and accuracy of umbilical arterial blood flow S/D value combined with fetal heart rate monitoring for fetal intrauterine distress were higher than single S/D value determination and fetal heart monitoring. Conclusion The determination of umbilical arterial blood flow S/D value combined with fetal heart rate monitoring has a high diagnostic value for fetal distress,which is important for preventing adverse pregnancy outcomes and improving perinatal prognosis.