妊娠晚期胎心监测及彩色多普勒超声参数预测胎儿宫内缺氧的价值  

Value of fetal heart rate and color Doppler ultrasound parameters in predicting fetal intrauterine hypoxia in the third trimester of pregnancy

作　　者：李慧 周杨 LI Hui;ZHOU Yang(Department of Ultrasound,Pingxiang People's Hospital,Pingxiang,Jiangxi,337200,China)

机构地区：[1]萍乡市人民医院超声科,江西萍乡337200

出　　处：《当代医学》2023年第22期44-47,共4页Contemporary Medicine

摘　　要：目的探讨妊娠晚期胎心监测及彩色多普勒超声大脑中动脉(MCA)、脐动脉(UA)参数预测胎儿宫内缺氧的价值。方法选取2018年3月至2021年5月本院收治的80名妊娠晚期产妇作为研究对象,将产后证实为宫内缺氧胎儿的28名孕妇作为缺氧组,将正常妊娠的52名孕妇作为对照组。监测两组妊娠晚期胎心情况,采用彩色多普勒超声检查MCA与UA的收缩期峰值流速/舒张末期血流速度比值(S/D)、搏动指数(PI)、阻力指数(RI),借助ROC分析MCA与UA的S/D、PI、RI对胎儿宫内缺氧的预测价值,最后通过一致性分析,评价妊娠晚期胎心、妊娠晚期胎心联合彩色多普勒超声MCA、UA对胎儿宫内缺氧的预测价值。结果缺氧组MCA的S/D、PI、RI明显低于对照组,UA的S/D、PI、RI明显高于对照组,差异有统计学意义(P<0.05)。缺氧组胎心监护异常率明显高于对照组,差异有统计学意义(P<0.05)。MCA的S/D、PI、RI预测胎儿宫内缺氧的AUC分别为0.787、0.783、0.736,UA的S/D、PI、RI预测胎儿宫内缺氧的AUC分别为0.895、0.815、0.820。80例胎儿中胎心监测检查阳性23例,Kappa为0.751。80例胎儿中彩色多普勒超声参数联合胎心监测检查结果为阳性26例,Kappa为0.864。结论妊娠晚期胎心及彩色多普勒超声MCA、UA联合评估胎儿宫内缺氧情况可为临床及时进行干预降低不良妊娠结局提供依据。Objective To explore the value of fetal heart rate and color Doppler ultrasound parameters of middle cerebral artery(MCA)and um-bilical artery(UA)in predicting fetal intrauterine hypoxia in the third trimester of pregnancy.Methods 80 pregnant women admitted to our hospital from March 2018 to May 2021 in the third trimester were selected as the research subjects,28 pregnant women who were confirmed as intrauterine hypoxia fetuses after delivery were selected as the hypoxia group,and 52 pregnant women with normal pregnancy were selected as the control group.The fetal heart rate of the two groups in the third trimester of pregnancy was monitored,the ratio of peak systolic velocity/end diastolic velocity(S/D),pulsatility index(PI)and resistance index(RI)of MCA and UA were examined by color Doppler ultrasound,the predictive value of S/D,PI and RI of MCA and UA on fetal intrauterine hypoxia was analyzed by ROC,the fetal heart rate in the third trimester of pregnancy and MCA combined with color Doppler ultrasound were evaluated by consistency analysis.Results The S/D,PI and RI of MCA in the hypoxia group were significantly lower than those in the control group,while the S/D,PI and RI of UA were significantly higher than those in the control group,the differences were statistically significant(P<0.05).The abnormal rate of fetal heart monitoring in the hypoxia group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The S/D,PI and RI of MCA predicted the AUC of 0.787,0.783 and 0.736 respective-ly,and the S/D,PI and RI of UA predicted the AUC of intrauterine hypoxia of 0.895,0.815 and 0.820 respectively.Among 80 fetuses,23 cases were positive in fetal heart monitoring,and Kappa was 0.751.Among 80 fetuses,the results of color Doppler ultrasound parameters combined with fetal heart monitoring were positive in 26 cases,and Kappa was 0.864.Conclusion The combination of fetal heart rate and color Doppler ultrasound MCA and UA in the third trimester of pregnancy can p

关 键 词：胎心 超声检查 大脑中动脉 脐动脉 胎儿宫内缺氧 

分 类 号：R714.5[医药卫生—妇产科学]