摘要
目的分析妊娠晚期脐带绕颈与胎儿大脑中动脉血流收缩期血流峰值/舒张期峰值(S/D)、搏动指数(PI)、阻力指数(RI)及胎儿宫内窘迫、剖宫产的关系。方法选择浙江省诸暨市人民医院2015年7月至2017年11月收治的共125例妊娠晚期脐带绕颈胎儿(观察组)与183例妊娠晚期非绕颈胎儿(对照组)作为研究对象,通过彩色多普勒超声仪测定两组胎儿大脑中动脉血流S/D、PI及RI值,并比较两组胎儿宫内窘迫与剖宫产率的差异。结果观察组胎儿大脑中动脉血流S/D、PI及RI值较对照组均显著升高(t值分别为5.76、6.97、4.27,均P<0.01)。观察组胎儿宫内窘迫、剖宫产率较对照组均显著升高(χ~2值分别为5.24、7.04,均P<0.05)。观察组孕周≥37周胎儿大脑中动脉血流S/D、PI及RI值较孕28~36周胎儿显著降低(t值分别为6.42、4.78、5.15,均P<0.01)。结论妊娠晚期脐带绕颈胎儿大脑中动脉血流动力学指标出现异常变化,可能与宫内窘迫、剖宫产率明显升高存在密切联系,因此产前应尽早评估胎儿大脑中动脉血流动力学参数的变化,以预防或降低宫内窘迫发生率,进而选择合适的分娩时机和方式。
Objective To analyze the relationship between umbilical cord around neck and fetal middle cerebral artery blood flow peak-systolic/diastolic-ratio （S/D）, pulsation index （PI）, resistance index （RI） and fetal distress and cesarean section. Methods A total of 125 fetuses with umbilical cord around neck （observation group） and 183 fetuses without umbilical cord around neck （control group） in late pregnancy in Zhuji People＇s Hospital of Zhejiang Province during July 2015 to November 2017 were selected as research objects. The S/D, PI, and RI values of blood flow in the middle cerebral artery of the fetuses were measured by color Doppler ultrasound, and the differences in the rate of intrauterine distress and cesarean section were compared between two groups. Results Compared with the control group, the S/D, PI and RI values in fetal middle cerebral artery were significantly higher in the observation group （t value was 5.76, 6.97 and 4.27, respectively, all P〈0.01）. The rate of intrauterine distress and cesarean section in the observation group were significantly higher than those in the control group （χ^2 value was 5.24 and 7.04, respectively, both P〈0.05）. In the observation group, the S/D, PI and RI values of hiood flow in middle cerebral artery in the fetuses whose gestational age were older than 37 weeks were significantly lower than those whose gestational age between 28 and 36 weeks （t value was 6.42, 4.78 and 5.15, respectively, all P〈0.01）. Conclusion The abnormal changes of hemodynamic parameters of blood flow in middle cerebral artery in the fetuses with umbilical cord around neck during late pregnancy may be closely related to the rate of significant increase of intrauterine distress and cesarean section. Therefore, the changes of hemodynamic parameters blood flow in middle cerebral artery in the fetuses should be assessed as soon as possible before birth so as to prevent or reduce the incidence of intrauterine distress and help to select appropriate timing and mode
作者
周丽
ZHOU Li(Department of Obstetrics and Gynecology, Zhuji People ＇ s Hospital of Zhejiang Province, Zhejiang Zhuji 311800, Chin)
出处
《中国妇幼健康研究》
2018年第3期368-371,共4页
Chinese Journal of Woman and Child Health Research
关键词
妊娠晚期
脐带绕颈
胎儿
大脑中动脉
宫内窘迫
剖宫产
late pregnancy
umbilical cord around neck
fetus
middle cerebral artery
intrauterine distress
cesarean section
