胎儿脑和脐动脉血流检测围生儿溶血的意义

Color doppler examination of umbilical and middle cerebral artery in fetal-maternal ABO incompatibility

目的 探讨对母儿ABO血型不合孕妇进行彩色多普勒超声检测胎儿大脑中动脉(MCA)及脐动脉(UA)血流的价值。方法 应用彩色多普勒超声,检测母儿ABO血型不合危险孕妇42例(危险组)、母儿ABO血型不合溶血病孕妇15例(溶血组)、正常妊娠孕妇48例(对照组)胎儿MCA及UA血流速度波形,计算胎儿UA血流速度波形收缩末期最大值(S)比舒张末期最大值(D)之比值(S/D)、搏动指数(PI)、阻力指数(RI)和胎儿MCA的PI、RI。结果 溶血组胎儿UA血流S/D、PI、RI值明显升高,与对照组和危险组比较,有显著性差异(P<0.05)。MCA血流RI、RI值各组间比较,无显著性差异(P>0.05)。结论 彩超检测UA和MCA血流值可作为临床观察母儿血型不合孕妇胎儿宫内溶血状况的一项参考指标。

Objective To evaluate the color Doppler examination of the umbilical and middle cerebral artery on fetal-maternal ABO incompatibility. Methods Color Doppler was used to examine the blood flow velocity waveforms of the umbilical artery(UA) and middle cerebral artery(MCA) in 15 pregnant women on fetal-maternal ABO incompatible hemolysis, 42 on fetal-maternal ABO incompatible risks and 48 normal pregnant women. The peak-systolic/ diastolic ratio(S/D) , pulsatile index(PI) and resistance index(RI) of UA and MCA were calculated respectively. Results There were significant differences in S/D, PI, RI of UA between newborns with and without ABO hemolytic disease (P <0. 05). No significant difference of between the blood flow parameters of fetal MCA was observed in all pregnant women. Conclusion It is valuable that fetal hemolysis can be detected non-invasively by color Doppler ultrasonography on the basis of UA and MCA blood flow values.