妊娠中期脐血流监测的临床意义  

Clinical significance of monitoring of umbilical artery systolic/diastolic ra-tio in the second trimester

作　　者：肖学茹[1] 张陈彦[1] 孙东霞[1] 张立新[1] 刘慧[1] 韩新宏 祁美玉 

机构地区：[1]石家庄市第一医院产科,河北石家庄050000

出　　处：《中国医药导报》2015年第30期98-101,共4页China Medical Herald

基　　金：河北省石家庄市科学技术研究与发展指导计划项目(131462643)

摘　　要：目的探讨妊娠中期脐动脉血流收缩期值与舒张期值之比（S／D）与妊娠并发症及围生儿不良结局的相关性。方法选择2012年8月～2014年2月在河北石家庄市第一医院门诊就诊的514例妊娠18～28周孕妇为研究对象，所有孕妇均采用彩色多普勒超声检测脐动脉血流S／D，并根据S／D值将其分为S／D〈3组257例（A组），3≤S／D〈4组112例（B组），4~〈S／D〈5组91例（C组），S／D≥5组37例（D组），脐动脉血流反流或消失组17例（E组），比较分析各组并发症及妊娠结局。结果C组妊娠期高血压疾病、胎儿生长受限、妊娠合并甲状腺功能减退、妊娠期糖尿病、羊水过少等并发症及羊水污染、新生儿窒息、小于胎龄儿等发生率均高于A组，差异均有统计学意义（P〈0．05）：D组羊水污染、新生儿窒息、小于胎龄儿、胎死宫内发生率明显高于A组，差异均有高度统计学意义（P〈0．01）。结论孕18．28周脐血流S／D值≥4时，需警惕妊娠期并发症及围生儿不良结局的发生，尽早干预，以期改善妊娠结局。Objective To explore the relationship between umbilical artery （UA） systolic/diastolic （S/D） value in the second trimester and maternal and neonatal outcomes. Methods 514 pregnant women with gestational age of 18-28 weeks from August 2012 to February 2014 in the First Hospital of Shijiazhuang City were selected as the study objects, all the pregnant women were given the detection of color Doppler ultrasound and UA S/D values were analyzed, and they were derided into 5 groups according UA S/D value： S/D〈3 group, 257 cases （group A）; 3≤S/D〈4 group, 112 cases （group B）; 4≤S/D〈5 group, 91 cases （group C）; S/D≥5 group, 37 cases （group D）; umbilical artery blood flow reflux or disappear group,17 cases （group E）. Pregnancy complications and neonatal outcomes of each group were com- pared and analyzed. Results Compared with group A, the risk of gestational hypertension disease, fetal growth restric- tion, pregnancy with hypothyroidism, gestational diabetes, oligohydramnios, amniotic fluid pollution, neonatal asphyxia and less than gestational age were increased in group C, the differences were statistically significant （P 〈 0.05）; inci- dence rate of amniotic fluid contamination, neonatal asphyxia, less than gestational age, and intrauterine death in the group D were significantly higher than those of the group A, the differences were statistically significant （P 〈 0.01）. Conclusion High UA S/D value （〉14） in second trimester might alert doctors to take interventions to prevent perinatal mortality and promote perinatal outcomes.

关 键 词：妊娠 脐动脉血流 S/D 妊娠并发症 围生儿不良结局 

分 类 号：R714.255[医药卫生—妇产科学]