胎儿大脑中动脉与脐动脉和孕妇子宫动脉血流动力学的监测与晚孕期胎儿宫内窘迫的相关性

The correlation between the hemodynamics of the middle cerebral artery,umbilical artery and pregnant women's uterine artery and fetal distress in late pregnancy

目的:探讨胎儿大脑中动脉(MCA)与脐动脉(UmA)和孕妇子宫动脉(UtA)血流动力学的监测与晚孕期(>32周)胎儿宫内窘迫的相关性。方法:将收治的30例晚孕期(>32周)胎儿胎心监测异常怀凝胎儿宫内窘迫孕妇作为观察组,另选取30例正常孕妇作为对照组,比较两组孕妇UtA及胎儿MCA、UmA水平,并统计分析两组新生儿Apgar评分。结果:观察组孕妇UtA的脐血流阻力指数(RI)、脐血流搏动指数(PI)、收缩/舒张比(S/D)值等指标均较对照组更高,差异有统计学意义(P<0.05);观察组胎儿MCA的PI、S/D值较对照组明显降低,而胎儿UmA的PI、S/D值均较对照组明显增高,差异有统计学意义(P<0.05),两组胎儿MCA及UmA的RI水平比较差异无统计学意义(P>0.05);观察组新生儿Apgar评分≤7分的比例(40.00%)较对照组(10.00%)明显更高,差异有统计学意义(P<0.05)。结论:孕晚期胎儿MCA、UmA和孕妇UtA水平出现较大血流动力学改变,对胎儿胎心监测异常怀凝胎儿宫内窘迫具有较好预测作用,对于早期指导临床干预方案具有重要意义,有助于降低新生儿死亡率。

Objective To investigate the relationship between the hemodynamics of MCA and umbilicus artery(UmA)and uterine artery(UtA)in pregnant women and fetal distress in late pregnancy(>32 weeks).Method 30 pregnant women with abnormal fetal fetal heart monitoring abnormal fetal distress during the late pregnancy period(>32 weeks)were treated in our hospital as observation group,and 30 normal pregnant women were selected as control group,and the levels of UtA,MCA and UmA were compared between the two groups,and Apgar_(s)cores of the two groups were analyzed statistically.Results The indexes of umbilical blood flow resistance index(RI),cord blood flow pulsatile index(PI),systolic/diastolic ratio(S/D)of the observation group were higher than those in the control group(P<0.05);The PI and S/D values of fetal MCA in the observation group were significantly lower than those in the control group,while the PI and S/D values of fetal UmA were significantly higher than those in the control group(P<0.05),There was no significant difference in RI levels of MCA and UmA between the two groups(P>0.05);The proportion of Apgar_(s)core≤7 in observation group(40.00%)was significantly higher than that of control group(10.00%)(P<0.05).Conclusion The changes of hemodynamics in MCA,UmA and UtA levels in the late pregnancy have a good predictive effect on fetal fetal fetal heart monitoring abnormal fetal distress.It is of great significance for early guidance of clinical intervention program and helps to reduce the mortality of newborn.