彩色多普勒超声检测孕晚期胎儿动脉阻力参数在高危妊娠围产儿结局评估中的应用价值

Application Value of Resistant Parameters of Fetal Artery in Late Pregnancy Detected by Color Doppler Ultrasound in Evaluation of Perinatal Outcomes in High-risk Pregnancy Women

目的探讨彩色多普勒超声检测孕晚期胎儿脐动脉(UA)和大脑中动脉(MCA)阻力参数在高危妊娠围产儿结局评估中的应用价值。方法选取2018年1月—2019年4月行彩色多普勒超声检查并有分娩结局的孕晚期(孕28~42周)孕妇230例作为研究对象,根据有无高危妊娠危险因素将其分为高危妊娠组(130例)和正常妊娠组(100例)两组。比较两组胎儿UA和MCA阻力参数[阻力指数(RI)、搏动指数(PI)、收缩期峰值血流速度与舒张末期血流速度比值(S/D)]及围产儿结局指标(出生孕周、新生儿体质量、出生1 min时Apgar评分≤7分和UA pH≤7.20)。结果高危妊娠组胎儿UA阻力参数RI、PI、S/D均高于正常妊娠组,胎儿MCA阻力参数RI、PI、S/D均低于正常妊娠组,差异有统计学意义(P<0.05或P<0.01)。高危妊娠组围产儿出生孕周小于正常妊娠组,出生体质量低于正常妊娠组,出生1 min Apgar评分≤7分和UA pH≤7.20所占比例高于正常妊娠组,差异均有统计学意义(P<0.05或P<0.01)。结论高危妊娠孕妇孕晚期彩色多普勒超声检测胎儿UA和MCA阻力参数RI、PI、S/D异常,且其围产儿早产、低体质量和窒息率高,不良妊娠结局增加。彩色多普勒超声检测孕晚期胎儿UA和MCA阻力参数RI、PI、S/D在高危妊娠围产儿结局评估中有重要应用价值。

Objective To explore application value of resistant parameters of umbilical artery(UA)and middle cerebral artery(MCA)in late pregnancy detected by color Doppler ultrasound in evaluation of perinatal outcomes of high-risk pregnancy women.Methods A total of 230 pregnant women in lategestation(28-42 weeks of gestation),who underwent color Doppler ultrasound examination between January 2018 and April 2019 and had delivery outcomes,were selected as research subjects,and the pregnant women were divided into high-risk pregnancy group(n=130)and normal pregnancy group(n=100)according to whether or not having risk factors of high-risk pregnancy.Values of resistant parameters of fetal UA and MCA[resistance index(RI),pulsatility index(PI),ratio of peak systolic blood flow velocity to end diastolic blood flow velocity(S/D)]and perinatal outcome indexes(gestational age,neonatal body weight,Apgar score less than or equal 7 scores at 1 min of birth and UA pH less than or equal 7.20)were compared between two groups.Results In high-risk pregnancy group,resistant parameters RI,PI and S/D of UA were significantly higher,while resistant parameters RI,PI and S/D of MCA were significantly lower than those in normal pregnancy group(P<0.05 or P<0.01).In the high-risk pregnancy group,values of gestational week of the perinatal infant and birth weight were significantly lower,while proportions of Apgar score less than or equal 7 score at 1 min of birth and UA pH less than or equal 7.20 were significantly higher than those in normal pregnancy group(P<0.05 or P<0.01).Conclusion Resistant parameters RI,PI and S/D of UA and MCA are abnormal detected by color Doppler ultrasound in high-risk pregnant women in late pregnancy,and rates of premature delivery,low body weight and neonatal asphyxia of perinatal infant are high,and adverse pregnancy outcomes are increased.Detections of resistant parameters RI,PI and S/D of MCA and UA by color Doppler ultrasound have important application value in late pregnancy in evaluation of perinatal outcomes of high-risk pregnancy women in clinic.