孕产妇脐血流及凝血功能检测对辅助预测特发性胎儿生长受限的价值

Value of Maternal Cord Blood Flow and Coagulation Function Test in Assisting Prediction of Idiopathic Fetal Growth Restriction

目的:分析孕产妇脐血流及凝血功能检测对辅助预测特发性胎儿生长受限的价值。方法:选取本院2019年12月-2020年12月进行B超估测胎儿体质量的100例正常体质孕妇作为研究对象,根据估测结果将特发性胎儿生长受限孕妇作为试验组,共48例,将胎儿体质量正常的孕妇作为参照组,共52例。两组均开展脐动脉血流检测[包括脐动脉收缩期最大血流速度与舒张末期血流速度比值(S/D)、搏动指数(PI)、阻力指数(RI)]和凝血功能检测[包括纤维蛋白原(FIB)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)],观察两组脐动脉血流检测结果和凝血功能检测结果差异,同时对两组母血血细胞比容(HCT)、血红蛋白(Hb)及分娩方式进行比较。结果:试验组脐动脉血流检测结果显示,S/D、PI及RI值和参照组比较均明显更高(P<0.05)。试验组HCT和Hb值与参照组比较差异均无统计学意义(P>0.05),且凝血功能检测结果显示,FIB、PT、TT、APTT及D-D值和参照组比较差异均无统计学意义(P>0.05)。参照组急诊剖宫产率为3.85%(2/52),试验组急诊剖宫产率为16.67%(8/48),试验组急诊剖宫产率明显高于参照组(P<0.05)。结论:孕产妇脐血流参数可以作为辅助预测特发性胎儿生长受限的可靠指标,能够为临床治疗带来一定参考依据,凝血功能不是特发性胎儿生长受限预测评估的可靠指标。

Objective:To analyze the value of maternal cord blood flow and coagulation function test to assist in predicting idiopathic fetal growth restriction.Method:From December 2019 to December 2020,100 pregnant women with normal physical who used B ultrasound to estimate fetal body mass were selected as the research object.According to the estimated results,48 pregnant women with idiopathic fetal growth restriction were selected as the experimental group,and 52 pregnant women with normal fetal body weight were selected as the reference group.Umbilical artery blood flow detection[including ratio of maximal systolic blood flow velocity to end-diastolic blood flow velocity (S/D),pulsatility index (PI) and resistance index (RI)]and coagulation function detection[including fibrinogen (FIB),prothrombin time (PT),thrombin time (TT) and activated partial thrombin time (APTT),D-dimer (D-D)]were carried out in both groups,the differences of umbilical artery blood flow and coagulation function between the two groups were observed,and the hemocyte ratio (HCT),hemoglobin (Hb) and delivery mode of maternal blood of the two groups were compared.Result:The test results of umbilical artery blood flow showed that S/D,PI and RI values in the experimental group were significantly higher than those in the reference group (P<0.05).There were no significant differences between the HCT and Hb values between the experimental group and the reference group (P>0.05),and the coagulation function test results showed that the FIB,PT,TT,APTT and DD values in the experimental group were not significantly different from the reference group,and the differences were not statistically significant (P>0.05).The rate of emergency cesarean section in the reference group was 3.85% (2/52),the rate of emergency cesarean section in the experimental group was 16.67% (8/48),which in the experimental group was significantly higher than that in the reference group (P<0.05).Conclusion:In the prediction of the occurrence of idiopathic fetal growth restriction,maternal cord blood flow parameters can be used as a reliable indicator for auxiliary prediction,which can bring a certain reference for clinical treatment.Coagulation function is not a reliable indicator for the prediction and evaluation of idiopathic fetal growth restriction.