基于彩超观察晚孕期羊水过少孕妇胎儿动脉血流特征与胎儿窘迫的关系  

Exploring the relationship between fetal arterial blood flow characteristics and fetal distress in late-trimester women with oligohydramnios based on color doppler ultrasound

作　　者：李晓庆 刘守福 马川入 程蔚然 温乔 LI Xiaoqing;LIU Shoufu;MA Chuanru;CHENG Weiran;WEN Qiao(Ziyang Central Hospital,Ziyang 641300,Sichuan,China)

机构地区：[1]资阳市中心医院,四川资阳641300

出　　处：《中南医学科学杂志》2025年第2期357-360,共4页Medical Science Journal of Central South China

基　　金：四川省卫生健康委员会科研课题(20PJ240)。

摘　　要：目的 探讨羊水过少孕妇胎儿动脉血流特征与胎儿窘迫发生的关系。方法 选取确诊的200例羊水过少妊娠晚期孕妇为观察组,观察组按胎儿是否窘迫分窘迫组52例、非窘迫组148例,另选择200例羊水量正常孕妇为对照组。分娩前用彩色多普勒超声检查查各组胎儿相关动脉血流参数特征并进行比较,采用ROC曲线分析羊水过少状态下胎儿血流动力学的特异性变化模式,并评估其对胎儿窘迫的预测价值。结果 观察组胎儿脐动脉和肾动脉的阻力指数(RI)、博动指数(PI)、收缩期最大血流速度与舒张末期速度之比(S/D)值高于对照组(P),大脑中动脉的RI、PI、S/D值低于对照组(P<0.05),主动脉峡部收缩期峰值流速(PSV)、收缩末期最低点流速(NS)、峡部收缩指数(ISI)值小于对照组(P)。窘迫组胎儿脐动脉和肾动脉的RI、PI、S/D值高于非窘迫组(P),大脑中动脉的RI、PI、S/D值低于非窘迫组(P),主动脉峡部PSV、NS、ISI值小于非窘迫组(P)。羊水过少胎儿脐动脉、肾动脉、大脑中动脉及主动脉峡部各参数预测胎儿窘迫发生具有一定价值。结论 羊水过少孕妇胎儿脐动脉、肾动脉血流、大脑中动脉、主动脉峡部参数变化可有效反映外周血流阻力增大、胎盘灌注不足及大脑血供不足,对于预测羊水过少胎儿发生窘迫具有重要价值。Aim To explore the relationship between fetal arterial blood flow characteristics and the occurrence of fetal distress in pregnant women with oligohydramnios.Methods A total of 200 late-trimester pregnant women diagnosed with oligohydramnios were selected as the observation group.The observation group was further divided into a distress group(52 cases) and a non-distress group(148 cases) based on the presence of fetal distress.Additionally,200 pregnant women with normal amniotic fluid volume were selected as the control group.Before delivery,color Doppler ultrasound was used to examine and compare the characteristics of fetal arterial blood flow parameters in each group.ROC curve analysis was employed to analyze the specific hemodynamic changes in fetuses under oligohydramnios and to evaluate their predictive value for fetal distress.Results In the observation group,the resistance index(RI),pulsatility index(PI),and systolic-to-diastolic ratio(S/D) of the umbilical artery(UA) and renal artery(RA) were significantly higher than those in the control group(P<0.05).In contrast,the RI,PI,and S/D of the middle cerebral artery(MCA) were lower than those in the control group(P<0.05).The peak systolic velocity(PSV),nadir systolic velocity(NS),and isthmic systolic index(ISI) of the aortic isthmus were also lower in the observation group compared to the control group(P<0.05).Within the observation group,the fetal distress subgroup exhibited higher RI,PI,and S/D values in the UA and RA compared to the non-distress subgroup(P<0.05),while the MCA showed lower RI,PI,and S/D values(P<0.05).Additionally,the aortic isthmus PSV,NS,and ISI values were significantly lower in the distress group(P<0.05).The blood flow parameters of the UA,RA,MCA,and aortic isthmus in fetuses with oligohydramnios demonstrated certain predictive value for fetal distress.Conclusion In pregnant women with oligohydramnios,changes in fetal blood flow parameters-including those of the umbilical artery,renal artery,middle cerebral artery,and aortic isthmus-can

关 键 词：羊水过少 胎儿 动脉血流参数 胎儿窘迫 彩色多普勒超声 预测 

分 类 号：R714[医药卫生—妇产科学]