四维能量多普勒超声对胎儿生长受限的早孕期预测价值

Predictive value of four-dimensional Doppler ultrasound in early pregnancy of fetal growth restriction

目的探究四维能量多普勒超声对胎儿生长受限(FGR)的早孕期预测价值。方法选取2019年3月—2020年3月河北省唐山市妇幼保健院分娩的367名正常单胎妊娠孕妇为研究对象,在颈后透明层检查时采用四维能量多普勒超声采集胎盘能量多普勒容积数据,利用GE 4D View软件计算血管化指数(VI)、血管化-血流指数(VFI)、血流指数(FI)。对所有孕妇进行电话随访至胎儿出生,根据诊断结果分为FGR组(59例)和对照组(308例)。比较两组胎盘体积(PV)、胎盘商(PQ)、左子宫动脉搏动指数(PI)、右子宫动脉PI、脐动脉收缩期/舒张期速度之比(S/D)、大脑中动脉PI及四维能量多普勒超声参数VI、VFI、FI,观察两组妊娠预后。结果FGR组PV、PQ、大脑中动脉PI低于对照组,左子宫动脉PI、右子宫动脉PI、脐动脉S/D高于对照组(均P<0.01)。FGR组VI、FI、VFI低于对照组(均P<0.01)。FGR组Apgar评分低于对照组(P<0.01);两组胎儿窘迫、新生儿窒息发生率比较,差异无统计学意义(P>0.05)。结论孕早期四维能量多普勒超声检测对于FGR的早期预测具有重要价值意义,胎儿孕早期VI、VFI指数是评估FGR的敏感指标,具有较高的临床诊断价值。

Objective To explore the predictive value of four-dimensional Doppler ultrasound in early pregnancy of fetal growth restriction(FGR).Methods A total of 367 normal single pregnant women who delivered in Tangshan Maternal and Child Health Hospital from March 2019 to March 2020 were selected as the research subjects.During nuchal translucency examination,placental energy Doppler volume data were collected by four-dimensional energy Doppler ultrasonography,and vascularization index(VI),vascularization-blood flow index(VFI)and blood flow index(FI)were calculated by GE 4D View software.All pregnant women were followed up by telephone until birth,according to the diagnosis results,they were devided into FGR group(59 cases)and control group(308 cases).Placental volume(PV),placental quotient(PQ),left uterine artery pulse index(PI),right uterine artery PI,umbilical artery systolic/diastolic velocity ratio(S/D),PI of middle cerebral artery and four-dimensional energy Doppler ultrasound parameters VI,VFI,FI were compared between two groups,and the pregnancy prognosis of two groups were observed.Results PV,PQ and PI of middle cerebral artery in FGR group were lower than those in control group,while left uterine artery PI,right uterine artery PI and S/D of umbilical artery in FGR group were higher than those in control group(all P<0.01).VI,FI and VFI of FGR group were lower than those of control group(all P<0.01).Apgar score of FGR group was lower than that of control group(P<0.01);there were no significant differences in the incidence of fetal distress and neonatal asphyxia between two groups(P>0.05).Conclusion Four-dimensional energy Doppler ultrasound detection in early pregnancy is of great value for the early prediction of FGR.VI and VFI indexes are sensitive indicators for the evaluation of FGR in early pregnancy,and have high clinical diagnostic value.