晚孕期羊水过少胎儿彩色多普勒超声血流检测预测胎儿妊娠结局的价值  

Value of Doppler blood flow detection in predicting pregnancy outcomes of oligopydramnios during the third trimester of pregnancy

作　　者：张锐[1] 王婷[1] 李百玲[1] 侯丽颖 ZHANG Rui;WANG Ting;LI Bai-Ling(Changchun Obstetrics and Gynecology Hosipital,Changchun,Jilin 130042,China)

机构地区：[1]长春市妇产医院,吉林长春130042

出　　处：《中国妇幼保健》2022年第19期3660-3664,共5页Maternal and Child Health Care of China

基　　金：吉林省卫生健康技术创新项目(2019J102)。

摘　　要：目的探讨晚孕期羊水量过少胎儿大脑中动脉(MCA)、脐动脉(UA)及脐静脉导管(DV)彩色多普勒超声血流动力学改变与胎儿不良妊娠结局的相关性。方法选取2020年1月—2021年12月在长春市妇产医院产检的159例晚孕期羊水过少孕妇为观察组,根据有无胎儿不良妊娠结局分为无不良妊娠结局组和不良妊娠结局组;另选取同期在该院产检的羊水量正常的100例晚孕期孕妇作为对照组。产前测量UA、MCA及DV血流动力学参数,对比分析其对胎儿不良妊娠结局的预测价值。结果对照组和观察组剖宫产率分别31.00%(31/100)、83.02%(132/159),两组比较,差异有统计学意义(χ^(2)=71.21,P<0.05)。观察组有41例(25.79%)出现不良妊娠结局,其中胎儿窘迫33例(20.75%),酸中毒4例(2.52%),新生儿窒息4例(2.52%),未出现围生儿死亡。不良妊娠结局组UA的S/D、PI及RI[(3.06±0.43)、(1.11±0.17)及(0.65±0.05)]均高于无不良结局组[(2.15±0.31)、(0.76±0.12)及(0.52±0.07)]和对照正常组[(2.11±0.28)、(0.76±0.12)及(0.52±0.06)],MCA的S/D、PI及RI[(3.38±0.36)、(1.22±0.14)及(0.67±0.04)]均低于无不良结局组[(4.14±0.39)、(1.47±0.12)及(0.75±0.03)]和对照组[(4.16±0.30)、(1.47±0.12)及(0.74±0.03)],差异均有统计学意义(F=145.673、103.478及70.476,F=81.098、67.122及87.926,均P<0.05);无不良结局组和对照组UA和MCA的S/D、PI及RI比较,差异均无统计学意义(均P>0.05)。不良妊娠结局组脑-胎盘比(1.14±0.23)低于无不良结局组(2.01±0.40)和对照组(2.00±0.38),差异有统计学意义(F=93.204,P<0.05);无不良结局组和对照组脑-胎盘比比较,差异无统计学意义(P>0.05)。3组DV的S/D、PI及RI比较,差异均无统计学意义(均P>0.05)。结论产前测量UA、MCA及DV血流动力学参数,可为临床预测羊水过少胎儿不良妊娠结局提供参考依据。Objective To explore the changes of Doppler hemodynamics of fetuses in oligohydramnios in the fetus UA,MCA,and DV during late pregnancy and the correlation of adverse pregnancy outcomes.Methods From January 2020 to December 2021,159 pregnant women in Changchun Obstetrics and Gynecology Hosipital with oligohydramnios were selected as observation group.According to the to adverse pregnancy outcome,all the cases were divided into no adverse pregnancy outcome group and adverse pregnancy outcome group.100 normal late pregnant women were included in the control group.Measuring the parameters of UA,MCA,DV hemodynamic before delivery and the results were compared to analyze its predictive value for adverse pregnancy outcome.Results The cesarean section rates in the observation group and the control group were 31.00%(31/100)and 83.02%(132/159),respectively,with statistical significance(χ^(2)=71.21,P<0.05).Among observation group,41 cases(25.79%)had adverse pregnancy outcomes,accounting for 33 cases(20.75%)were fetal distress,4 cases(2.52%)had acidosis,and 4 cases(2.52%)showed neonatal asphyxia,with no perinatal death.The S/D,PI and RI of UA[(3.06±0.43),(1.11±0.17),(0.65±0.05)]inadverse pregnancy outcomes group were higher than those in no adverse pregnancy outcome group[(2.15±0.31),(0.76±0.12),(0.52±0.07)]and control group[(2.11±0.28),(0.76±0.12),(0.52±0.06)].The S/D,PI and RI[(3.38±0.36),(1.22±0.14),(0.67±0.04)]of MCA were lower than those in no adverse pregnancy outcome group[(4.14±0.39),(1.47±0.12),(0.75±0.03)]and control group[(4.16±0.30),(1.47±0.12),(0.74±0.03)]and the difference was statistically significant(F=145.673,103.478 and 70.476 of UA,F=81.098,67.122 and 87.926 of MCA,all P<0.05).There was no significant difference in RI,PI and S/D of UA and MCA between no adverse pregnancy outcome group and control group(all P>0.05).The Cerebroplacental Ratio of adverse pregnancy outcome group(1.14±0.23)was lower than no adverse outcome group(2.01±0.40)and control group(2.00±0.38)(F=93.204,P<0.05).Ther

关 键 词：胎儿 彩色多普勒超声 大脑中动脉 脐动脉 脐静脉导管 羊水过少 妊娠结局 

分 类 号：R714[医药卫生—妇产科学]