改进型超声生物物理评分对胎儿宫内窘迫的预测价值  

Predictive value of improved ultrasound biophysical score for intrauterine fetal distress

作　　者：邓彦明 万建芳 范涛 黄惠 DENG Yanming;WAN Jianfang;FAN Tao;HUANG Hui(Department of Ultrasound Medicine,Shanghai Pudong Hospital,Shanghai 201399,China)

机构地区：[1]上海市浦东医院复旦大学附属浦东医院超声医学科,上海201399

出　　处：《陕西医学杂志》2022年第8期970-973,共4页Shaanxi Medical Journal

基　　金：上海市浦东新区卫生健康委员会卫生科技发展专项基金资助项目(PW2020B-9)。

摘　　要：目的:探究改进型超声生物物理评分对胎儿宫内窘迫的预测价值。方法:选取正规产检的孕34~37周孕妇86例为研究对象,利用改进型超声生物物理评分对胎儿进行综合评分,将孕妇分为A组(8~10分,n=49)、B组(5~7分,n=21)和C组(0~4分,n=16)。所有孕妇均行脐动脉血流监测及胎心监护(NST),比较各组脐动脉收缩期与舒张期流速比值(S/D)、NST监测结果、新生儿Apgar评分、宫内窘迫发生率和新生儿不良事件发生情况,分析改进型超声生物物理评分预测胎儿宫内窘迫的灵敏度、特异度和准确度。结果:A组脐动脉S/D值、无反应型比例均低于B、C组,差异均有统计学意义(均P<0.05)。各组新生儿Apgar评分比较:A组>B组>C组,宫内窘迫发生率比较:A组<B组<C组,差异均有统计学意义(均P<0.05);A组低体重出生、生长受限和缺血缺氧性脑病发生率均低于B、C组(均P<0.05)。脐动脉S/D值≥3孕妇的新生儿Apgar评分明显小于脐动脉S/D值<3孕妇,宫内窘迫发生率高于脐动脉S/D值<3孕妇(均P<0.01)。反应型孕妇新生儿Apgar评分明显高于无反应型,宫内窘迫发生率低于无反应型孕妇,差异均有统计学意义(均P<0.05)。改进型超声生物物理评分预测胎儿宫内窘迫的灵敏度、特异度、准确度高于脐动脉血流监测和NST监测,差异有统计学意义(均P<0.05)。结论:改进型超声生物物理评分在预测胎儿宫内窘迫方面具有较高的灵敏度和准确度,能够较为准确地对胎儿宫内窘迫进行预测。Objective:To explore the predictive value of improved ultrasound biophysical score for intrauterine fetal distress.Methods:A total of 86 pregnant women at 34 to 37 weeks of gestation who received regular production inspection were selected as the research subjects.The fetuses were comprehensively scored by using improved ultrasound biophysical score,and the pregnant women were divided into group A(8 to 10,49 cases),group B(5 to 7,21 cases)and group C(0 to 4,16 cases)according to the score.All pregnant women received umbilical artery blood flow monitoring and fetal heart rate monitoring(NST).The umbilical artery systolic to diastolic flow velocity(S/D)ratio,NST monitoring results,neonatal Apgar score,the incidence of intrauterine distress and the occurrence of adverse events in newborns were compared between the groups.The sensitivity,specificity and accuracy of improved ultrasound biophysical score in predicting intrauterine fetal distress were analyzed.Results:The umbilical artery S/D and the proportion of reactive type in group A were higher than those in group B and group C(all P<0.05).Neonatal Apgar scores of group A,group B,and group C decreased in sequence,and the incidence of intrauterine distress increased in sequence from group A,group B to group C(all P<0.05).The incidence of low birth weight,growth restriction and hypoxic-ischemic encephalopathy in group A were lower than those in group B and C(all P<0.05).The neonatal Apgar score of pregnant women with umbilical artery S/D≥3 was significantly lower than that of pregnant women with umbilical artery S/D<3,and the incidence of intrauterine distress was higher than that in pregnant women with umbilical artery S/D<3(all P<0.01).The neonatal Apgar score of reactive pregnant women was significantly higher than that of non-reactive pregnant women,and the incidence of intrauterine distress was lower than that in non-reactive pregnant women.The sensitivity,specificity and accuracy of improved ultrasound biophysical score in predicting intrauterine fetal distr

关 键 词：宫内窘迫 胎儿 脐动脉血流监测 胎心监护 预测价值 

分 类 号：R714.7[医药卫生—妇产科学]