胎儿窘迫患儿超声血流动力学参数变化及预测价值

Changes and predictive value of ultrasonic hemodynamic parameters in children with fetal distress

目的探究胎儿窘迫患儿超声血流动力学参数变化及预测价值。方法对130例妊娠晚期孕妇临床资料进行回顾性分析,根据胎心率、羊水情况等胎儿窘迫诊断分为胎儿窘迫组(n=47)和对照组(n=83)。分别比较两组孕妇妊娠中期胎儿脐动脉(UA)和大脑中动脉(MCA)的收缩末期最大血流速度和舒张末期最大血流速度之比(S/D)、搏动指数(PI)及阻力指数(RI)差异。以受试者工作特征(ROC)曲线描述上述指标应用于孕妇于妊娠晚期出现胎儿窘迫的预测效能。结果胎儿窘迫组UA的S/D、PI和RI水平均高于对照组(均P<0.05),胎儿窘迫组MCA的S/D*、PI*和RI*水平均低于对照组(均P<0.05),其预测妊娠晚期发生胎儿窘迫的截断值分别为4.25、1.99、0.70、4.12、0.70、1.37。结论妊娠中期胎儿UA和MCA的S/D、PI、RI水平与妊娠晚期胎儿窘迫发生情况密切相关,其检测有较高的胎儿窘迫预测价值,可为改善胎儿围产期质量提供检测方法。

Objective To explore the changes and predictive value of ultrasonic hemodynamic parameters in children with fetal distress.Methods The clinical data of 130 late pregnant women were analyzed retrospectively.According to the fetal heart rate,amniotic fluid and other fetal distress diagnosis,they were divided into fetal distress group(n=47)and control group(n=83).The differences of S/D,PI and RI between UA and MCA were compared.The ROC curve was used to describe the predictive effect of the above indicators on fetal distress in late pregnancy.Results The levels of S/D,PI and RI of UA in the fetal distress group were significantly higher than those in the control group(P<0.05),and the levels of S/D,PI and RI of MCA in the fetal distress group were significantly lower than those in the control group(P<0.05).The cutoff values of predicting fetal distress in the late pregnancy were 4.25,1.99,0.70,4.12,0.70 and 1.37,respectively.Conclusion The levels of S/D,PI and RI of UA and MCA in the second trimester of pregnancy are closely related to the occurrence of fetal distress in the third trimester of pregnancy.The detection of UA and MCA has a high predictive value for fetal distress,and can provide a detection method for improving the quality of perinatal fetus.