NST联合脐动脉血流预测胎儿宫内窘迫的价值

The Value of NST Combined with Umbilical Artery Blood Flow in Predicting Fetal Distress

目的探究胎心无负荷试验(NST)联合脐动脉(UA)血流预测胎儿宫内窘迫的价值。方法选取2018年3月至2021年3月于本院进行分娩的单胎妊娠孕产妇72例,依据分娩结果及胎儿宫内窘迫的诊断标准,将发生宫内窘迫的26例孕产妇设为宫内窘迫组,未发生宫内窘迫的46例孕产妇设为正常组,所有研究对象均在分娩前行NST监测和UA血流检测。比较两组孕产妇的UA血流检测参数及NST监测结果,采用受试者特征曲线(ROC)分析UA血流检测参数联合NST监测预测胎儿在宫内窘迫的价值。结果UA血流检测与NST监测结果显示,宫内窘迫组UA血流检测指标RI、S/D值明显较正常组高,PI值明显较正常组低(P<0.05),宫内窘迫组与正常组胎心异常率分别为73.08%、17.39%,宫内窘迫组显著较正常组高(P<0.05);ROC曲线分析结果显示,血流阻力指数(RI)、UA收缩及舒张末期最大流速比值(S/D)、搏动指数(PI)、NST监测预测胎儿在宫内窘迫的AUC分别为0.727(95%CI:0.601~0.852)、0.718(95%CI:0.592~0.844)、0.727(95%CI:0.606~0.847)、0.778(95%CI:0.660~0.897),以上指标联合预测胎儿宫内窘迫的AUC为0.917(95%CI:0.838~0.996),明显高于各项指标单独预测值(P<0.05)。结论NST联合UA血流对预测胎儿宫内窘迫效能良好,UA血流检测参数异常及NST监测为无反应型,表示胎儿发生宫内窘迫风险高,可为临床产科早期干预指导提供有效依据。

Objective To explore the value of fetal heart no-stress test(NST)combined with umbilical artery(UA)blood flow in predicting fetal distress.Methods A total of 72 pregnant women with singleton pregnancy who gave birth in our hospital from March 2018 to March 2021 were selected.According to the delivery results and the diagnostic criteria for fetal distress,26 pregnant women with intrauterine distress were set as intrauterine distress.In the distress group,46 pregnant women without intrauterine distress were set as the normal group,and all the subjects underwent NST monitoring and UA blood flow detection before delivery.The UA blood flow detection parameters and NST monitoring results were compared between the two groups,and the receiver characteristic curve(ROC)was used to analyze the value of UA blood flow detection parameters combined with NST monitoring in predicting fetal distress.Results The results of UA blood flow detection and NST monitoring showed that the RI and S/D values of UA blood flow detection indexes in the intrauterine distress group were significantly higher than those in the normal group,and the PI value was significantly lower than that in the normal group(P<0.05).The abnormal fetal heart rate in the normal group was 73.08%and 17.39%,respectively,and the intrauterine distress group was significantly higher than that in the normal group(P<0.05).The AUC of(S/D),pulsatility index(PI),and NST monitoring in predicting fetal distress were 0.727(95%CI:0.601-0.852),0.718(95%CI:0.592-0.844),0.727(95%CI:0.606-0.847),0.778(95%CI:0.660-0.897),the AUC of the above indicators combined to predict fetal distress was 0.917(95%CI:0.838-0.996),which was significantly higher than the predicted value of each indicator alone(P<0.05).Conclusion NST combined with UA blood flow has a good effect in predicting fetal distress.Abnormal UA blood flow detection parameters and non-responsive NST monitoring indicate a high risk of fetal intrauterine distress,which can provide an effective basis for early intervention guidance in clinical obstetrics.