彩色多普勒超声检测脐动脉血流对评价胎儿宫内窘迫的临床应用价值

Detected by color Doppler ultrasound of umbilical artery blood flow evaluation of fetal distress and its clinical application value

目的通过超声检测晚期妊娠胎儿脐动脉血流,探讨其与胎儿宫内窘迫发生的相关性,分析其预测围生儿预后的临床应用价值。方法采用彩色多普勒超声对320例孕32~41周单胎孕妇进行产前超声检查,观察胎儿有无脐带绕颈、羊水透声情况,同时测定脐动脉S/D、RI值;将所选病例分为有脐绕颈组和无脐绕颈组,有宫内窘迫组和无宫内窘迫组,脐动脉血流正常组和异常组,对检测数据进行对照分析,并追踪其妊娠结局和分娩方式,最后结合分娩方式及产后1 min Apgar评分进行分析。结果与无脐带绕颈组相比,脐带绕颈组发生胎儿宫内窘迫风险高(P<0.05)。发生胎儿宫内窘迫组脐动脉血流S/D、RI值与未发生胎儿宫内窘迫组比较,高于无胎儿宫内窘迫组脐动脉血流S/D、RI值(P<0.05)。正常组与胎儿脐动脉血流异常组比较,正常组胎儿宫内窘迫、剖宫产率、羊水污染及APqar评分<7明显高于正常组(P<0.05)。结论彩色多普勒超声检测胎儿脐动脉血流对评价胎儿宫内窘迫、指导分娩方式、降低围生儿死亡率有重要的临床应用价值。

Objective To investigate the correlation between the fetal distress and umbilical artery,and to evaluate the clinical value of its prediction of the prenatal prognosis children. Methods 320 cases of pregnancy 33- 41 weeks were performed pregnancy prenatal ultrasound by using color Doppler ultrasound,and fetal nuchal cord,amniotic fluid,transparent sound were observed,and the simultaneous determination of umbilical artery S / D,RI values have selected there umbilical cord around neck which were divided into groups with and without umbilical cord around the neck group. There were fetal distress group and no fetal distress group,umbilical artery normal and abnormal groups which be compared by the test data,and tracked their pregnancy outcomes and mode of delivery,and postpartum. Finally,one minute Apgar scores were analyzed. Results Comparing with no cord around the neck with cord around the neck group,nuchal cord group had a high risk of fetal distress,the difference has statistically significant( P < 0. 05); Compared fetal distress group umbilical artery S / D,RI value of fetal distress group with the no- occur umbilical artery S / D,RI values,the fetal distress group umbilical artery S / D,RI was significantly higher than the group without fetal distress umbilical artery S / D,RI value,the difference was statistically significant( P < 0. 05); Compared the normal fetal umbilical artery blood flow group( S / D < 3. 0 and RI < 0. 6) with abnormal group( S / D > 3. 0; RI > 0. 6),the abnormal umbilical artery blood flow group had more fetal distress,cesarean section rate,amniotic fluid contamination,,and Apgar score < 7 was significantly higher than normal group,( P < 0. 05). Conclusion Color Doppler ultrasonic detection of fetal umbilical artery blood flow has important clinical value to the evaluation of fetal distress,guide the childbirth way.