孕妇子宫动脉及胎儿大脑中动脉、肾动脉血流参数预测高龄孕妇胎儿宫内窘迫的价值  

Predictive value for fetal distress in elderly pregnant women by blood flow parameters of pregnancy uterine artery and fetal middle cerebral artery and renal artery

作　　者：程志华[1] 杨瑞敏[1] 刘翔宇[1] 石克威 牛亚军[1] 赵春桃[1] 张力维[1] 赵灿 CHENG Zhihua;YANG Ruimin;LIU Xiangyu(Department of Ultrasound Diagnosis,the First Affiliated Hospital of Hebei North University,Hebei,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院超声医学科,河北省张家口市075000 [2]河北北方学院附属第一医院产科,河北省张家口市075000 [3]河北北方学院附属第一医院河北北方学院,河北省张家口市075000

出　　处：《河北医药》2024年第18期2768-2771,2775,共5页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20211138)。

摘　　要：目的探讨孕妇子宫动脉(UtA)及胎儿大脑中动脉(MAC)、肾动脉(RA)血流参数预测高龄孕妇胎儿宫内窘迫的价值。方法选取2021年3月至2023年6月在河北北方学院附属第一医院建档、产检并住院分娩的高龄孕妇163例作为研究对象,其中符合胎儿宫内窘迫的孕妇43例为研究组,正常分娩的孕妇120例为对照组,应用脉冲多普勒技术获取孕妇UtA、胎儿MAC、胎儿RA频谱图,测量血流参数:收缩期峰值血流速度/舒张末期血流速度(S/D)、搏动指数(PI)、阻力指数(RI),比较2组上述动脉各血流参数。结果2组间孕妇年龄、孕周差异无统计学意义(P>0.05)。与对照组比较,研究组孕妇UtA的S/D、PI、RI均增高(P<0.05);研究组胎儿MAC的S/D、PI、RI均减低(P<0.05);研究组胎儿RA的S/D、PI、RI均增高(P<0.05);研究组胎儿RA和胎儿MAC的S/D、PI、RI比值均增高(P<0.05)。研究组胎儿RA和胎儿MAC的S/D、PI、RI比值与孕妇UtA的S/D、PI、RI均呈正相关(P<0.05)。结论孕妇UtA、胎儿MAC、胎儿RA血流参数相互补充,可以作为预测高龄孕妇胎儿宫内窘迫发生与否的重要监测指标。Objective To explore the predictive value of fetal distress in elderly pregnant women using blood flow parameters of pregnancy uterine artery(UtA),fetal middle cerebral artery(MCA),and renal artery(RA).Methods A total of 163 elderly pregnant women,who registered,examined and delivered in the First Affiliated Hospital of Hebei North University from March 2021 to June 2023,were selected as the study subjects,including 43 pregnancy with fetal distress(study group)and 120 pregnancy with normal birth(control group).Pulse Doppler technology was used to obtain spectrograms of pregnancy UtA,fetal MAC and RA.Blood flow parameters were measured,including peak systolic blood flow velocity/end-diastolic velocity(S/D),pulsatility index(PI),resistance index(RI)were compared between the two groups.Results There was no significant difference in age and gestational age between the two groups(P>0.05).Compared with the control group,S/D,PI and RI of pregnancy UtA in the study group were significantly increased(P<0.05),S/D,PI and RI of fetal MAC were significantly decreased(P<0.05),and S/D,PI and RI of fetal RA were significantly increased(P<0.05).The S/D,PI and RI values of fetal RA and MAC were significantly increased in the study group(P<0.05).The S/D,PI and RI values of fetal RA and MAC in the study group were positively correlated with the S/D,PI and RI of UtA in pregnant women.Conclusion The blood flow parameters of Uta,fetal MCA and RA complement each other,which can be used as an important indicator to predict the occurrence of fetal distress in elderly pregnant women.

关 键 词：子宫动脉 大脑中动脉 肾动脉 高龄孕妇 胎儿 宫内窘迫 

分 类 号：R714.5[医药卫生—妇产科学]