胎儿肾动脉、大脑中动脉及静脉导管分流率检查对诊断妊高症患者胎儿宫内窘迫的临床价值

Clinical value of fetal renal artery,middle cerebral artery and venous catheter shunt rate in the diagnosis of fetal intrauterine distress in pregnancy-induced hypertension

探讨胎儿肾动脉、大脑中动脉及静脉导管分流率检查对诊断妊高症患者胎儿宫内窘迫的临床价值。比较胎儿宫内窘迫并在本院行剖宫产的妊高症孕妇和健康产妇的胎儿胎心率,肾动脉和大脑中动脉阻力指数(RI)、搏动指数(PI)及收缩末期峰值(S)与舒张末期峰值(D)的比值(S/D)以及脐静脉导管(DV)分流率,并进行多因素分析。结果显示,妊高症产妇的胎儿胎心率增快,肾动脉的RI、PI、S/D均显著升高,大脑中动脉RI、PI、S/D以及静脉导管分流率均显著降低;胎心率、胎儿肾动脉RI、PI、S/D与胎儿宫内窘迫发生呈正相关,大脑中动脉RI、PI、S/D以及静脉导管分流率与胎儿宫内窘迫发生呈负相关;胎心监护联合彩色多普勒超声检查胎儿肾动脉、大脑中动脉各项指标和静脉导管分流率的灵敏度、特异度以及阳性率均显著高于单纯胎心监护检查。

To explore the clinical effect of fetal renal artery,middle cerebral artery and venous catheter shunt rate in the diagnosis of intrauterine fetal distress in patients with pregnancy induced hypertension.The pregnant women with pregnancy-induced hypertension who were suspected to have intrauterine distress and healthy pregnant women whose fetal heart rate,renal artery and middle cerebral artery resistance index(RI),pulsatility index(PI),S/D and ductus venous(DV)shunt rate,were compared and analyzed.Results show,the fetus s fetal heart rate,renal artery RI,PI,S/D were significantly higher in the pregnant induced hypentesion women,RI,PI,S/D of middle cerebral artery and shunt rate of venous catheter were significantly lower.Fetal heart rate,RI,PI,S/D of fetal renal artery were positively correlated with fetal distress,while RI,PI,S/D of fetal middle cerebral artery and shunt rate of venous catheter were negatively correlated with fetal distress.The sensitivity,specificity and positive rate of color Doppler ultrasonography in examining fetal renal artery,middle cerebral artery and venous catheter shunt rate were significantly higher than those of simple fetal heart monitoring alone.