四维彩色多普勒超声联合唐氏筛查诊断胎儿生长受限的临床价值

Clinical value of four-dimensional color Doppler ultrasound combined with Down's screening in the diagnosis of fetal growth restriction

目的分析四维彩色多普勒超声联合唐氏筛查诊断胎儿生长受限的临床价值。方法以2020年1月至2022年12月我院收治的40例疑似存在胎儿生长受限的孕产妇为本次研究的观察组,再以同期到我院进行产检的40例正常健康胎儿的孕产妇为本次研究的对照组。所有孕产妇均先行四维彩色多普勒超声检查,再行唐氏筛查。比较四维彩色多普勒超声、唐氏筛查单一检查与联合检查对胎儿生长受限的诊断价值。结果观察组的胎盘体积小于对照组,血流搏动指数(PI)、收缩期最大血流速度与舒张期最低血流速度比值(S/D)、阻力指数(RI)高于对照组(P<0.05)。观察组的游离雌三醇(uE3)水平低于对照组,甲胎蛋白(AFP)、游离β-人绒毛膜促性腺激素(β-hCG)水平均高于对照组(P<0.05)。四维彩色多普勒超声与唐氏筛查对胎儿生长受限的诊断效能比较,差异无统计学意义(P>0.05);联合检查对胎儿生长受限的诊断特异度、阳性预测值与单一检查比较,差异无统计学意义(P>0.05);联合检查对胎儿生长受限的诊断准确度、灵敏度、阴性预测值均高于单一检查(P<0.05)。结论四维彩色多普勒超声联合唐氏筛查诊断胎儿生长受限可取得较高的诊断价值。

Objective To analyze the clinical value of four-dimensional color Doppler ultrasound combined with Down's screening in the diagnosis of fetal growth restriction.Methods Forty pregnant women with suspected fetal growth restriction admitted in our hospital from January 2020 to December 2022 were selected as the observation group of this study,and 40 pregnant women with normal healthy fetuses who underwent prenatal examination in our hospital during the same period were selected as the control group of this study.All pregnant women were first examined by four-dimensional color Doppler ultrasound,and then Down's screening was performed.The diagnostic value of four-dimensional color Doppler ultrasound,Down's screening single examination and combined examination for fetal growth restriction was compared.Results The placental volume of the observation group was less than that of the control group,and the pulsatility index(PI),the ratio of the maximum systolic blood flow velocity to the minimum diastolic blood flow velocity(S/D)and the resistance index(RI)were higher than those of the control group(P<0.05).The level of unconjugated estriol(uE3)in the observation group was lower than that in the control group,and the levels of alpha-fetal protein(AFP)and free β-human chorionic gonadotrophin(β-hCG)were higher than those in the control group(P<0.05).There was no significant difference in the diagnostic efficacy of four-dimensional color Doppler ultrasound and Down's screening for fetal growth restriction(P>0.05);there were no significant differences in the diagnostic specificity and positive predictive value of fetal growth restriction between combined examination and single examination(P>0.05);the diagnostic accuracy,sensitivity and negative predictive value of combined examination for fetal growth restriction were higher than those of single examination(P<0.05).Conclusion Four-dimensional color Doppler ultrasound combined with Down's screening in the diagnosis of fetal growth restriction can achieve higher diagnostic value.