影响新生儿出生状况的孕晚期超声指标多因素临床研究

Influencing factors on the staus of neonates detected by ultrasound examination for pregnant women in late-gestation

目的研究孕晚期胎儿超声指标对新生儿出生状况的影响。方法1250例分娩的孕产妇以出生后胎儿体重分组,分为巨大儿组(体重>4000 g),正常体重组(2500~4000 g),低体重儿组(<2500 g)。分析3组产妇的基本情况,比较晚孕期超声检查指标,分析其预测价值。1250例产妇按照胎儿出生后Apgar评分分组,低评分组(<8分),评分正常组(8~10分)。分析2组产妇的基本情况,比较孕晚期超声各项指标,分析其临床意义。结果巨大儿组产妇合并糖尿病的发生率明显高于正常体重组和低体重组,而低体重儿组产妇合并高血压的发生率亦明显高于其他2组,低体重儿组和巨大儿组其他妊娠合并症的发生率亦高于正常体重组,差异有统计学意义(P<0.05)。低体重组新生儿在娩出时体重低于正常,除了和孕周有一定的关系,与脐动脉的S/D及大脑中动脉的S/D、RI、PI指标亦有一定的关系,低体重儿组脐动脉的S/D比同孕周高,而大脑中动脉的S/D、RI、PI指标低于正常体重组和巨大儿组,差异(P<0.05)有意义,低体重儿组羊水过少的发生率较其他2组高,而巨大儿组羊水过多的发生率较高。低评分组产妇合并糖尿病、高血压、甲状腺疾病、心脏病、子宫畸形的发生率明显高于评分正常组,差异有统计学意义(P<0.05)。孕晚期超声检查中,低评分组胎儿的脐动脉S/D指标≥3.0的产妇较多,羊水过多或者过少的发生率较高与评分正常组比较,差异有统计学意义(P<0.05),低评分组BPS较低,一般≤4分,差异有统计学意义(P<0.05)。结论分析孕晚期超声检查的各项指标对于非正常妊娠结局的预测,效果理想,对于提早临床干预、治疗,避免非正常妊娠结局有着深远意义,值的进一步研究。

Objective To investigate the effects of ultrasound parameters on the staus of neonates detected by ultrasound examination for pregnant women in late-gestation.Methods According to the body weight,a total of 1250 neonates were divided into macrosomia group(body weight>4,000g),normal weight group(2,500~4,000g),low weight group(<2,500g).And 1250 parturients were divided into two groups according to Apgar score:low score group(<8 points)and normal score group(8~10 points).The basic situation and ultrasonic parameters were observed and compared to analyze its clinical significance.Results The incidence rate of diabetes mellitus in parturients in macrosomia group was significantly higher than that in normal weight group and low weight group(P<0.05),and the incidence of hypertension in parturients in low weight group was significantly higher than that in the other two groups(P<0.05).Moreover the incidence rates of diabetes mellitus,hypertension,heart disease,uterine malformation hypertension in low score group were significantly higher than those in normal score group(P<0.05).The levels of S/D,RI,PI in low weight group were significantly lower than those in the other two groups(P<0.05).The ultrasound examination results showed that the parturients with S/D≥3.0 were more,and the incidence rates of polyhydramnios or oligohydramnios in low score group were significantly higher than those in normal score group(P<0.05).Moreover the BPS levels in low score group were significantly lower(≤4 points,P<0.05).Conclusion The ultrasound examination results for pregnant women in late-gestation have important significance in predicting bad pregnancy outcome,and it is necessary to take early clinical intervention and treatment to avoid bad pregnancy outcome.