监测胎儿血流速度波形对估计高危妊娠胎儿预后的价值  

The estimation of fetal prognosis of high risk pregnancy by monitoring fetal blood flow index

作　　者：杜娟[1] 夏亚军[1] 尚涛[1] 

机构地区：[1]中国医科大学第二临床学院妇产科,沈阳110004

出　　处：《中国实用妇科与产科杂志》2002年第9期540-542,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　通过大样本临床监测结果 ,分析血流速度波形对估计胎儿宫内状况的价值。方法　检测 718例高危妊娠胎儿的脐动脉 (UA)、大脑中动脉 (MCA)血流波形 ,以胎儿出生时脐动脉血pH <7 19、1分钟Apgar评分≤ 7分、出生体重低于同孕周标准体重第 10百分位数以下为胎儿窘迫的诊断标准。分析血流速度波形指数异常诊断胎儿窘迫的敏感度和特异性。结果　各项指标诊断胎儿窘迫的敏感度和特异性分别为 :UA -RI为4 9 8%、96 6 % ;UA -PI为 4 9 3%、95 6 % ;MCA -RI为 34 0 %、96 5 % ;MCA -PI为 2 1 5 %、97 3%。结论　胎儿UA、MCA血流速度波形对诊断胎儿窘迫特异性较高 ,但敏感度仍然有限 。Objective To study if the fetal resistance index (RI) and plusatility index (PI) of the umbilical artery (UA) and middle cerebral artery (MCA) can determine the intrauterine conditions of fetus.Methods The RI and PI of UA and MCA were analysed in 718 cases of high risk pregnancy 1 week before delivery.Neonates whose UA pH<7 19,Apgar score≤7,birth weight below the 10th percentile were regarded as having fetal distress.We evaluated the sensitivity and specificity of abnormal blood flow index to predict fetal distress.Results The sensitivity and specificity were as follows:UA-RI 49 8%,96 6%;UA-PI 49 3%,95 6%;MCA-RI 34 0%,96 5% and MCA-PI 21 5%,97 3%.Conclusion Monitoring fetal UA and MCA flow waves by pulsed Doppler ultrasound is highly spectific,while sensitivity is limited in diagnosing the fetal distress.For clinical use these two indexes in the diagnosis of fetal distress should be combined with other examinations.

关 键 词：血流速度波形 高危妊娠 预后 彩色多普勒超声 胎儿监护 胎儿窘迫 

分 类 号：R714.43[医药卫生—妇产科学]