摘要
目的 探讨帆状胎盘孕妇预后与产前超声检查中胎儿脐动脉血流参数的关系。方法 选取我院帆状胎盘的孕妇105例(病例组),根据妊娠结局将病例组分为预后良好组65例,预后不良组40例。将同期正常妊娠结局良好的非帆状胎盘孕妇40例设为对照组。应用超声脉冲多普勒获取胎儿脐动脉收缩期峰值流速与舒张期末期流速的比值(S/D值)、血管阻力指数。分析正常胎盘及帆状胎盘的超声声像图;比较各组产前胎儿脐动脉血流参数(S/D值、血管阻力指数);对病例组的S/D比值与血管阻力指数值进行相关性分析;分析产前胎儿脐动脉血流参数对预后不良的诊断价值,计算ROC曲线下区域,统计各指标的诊断效能。结果 正常对照组中预后良好组、预后不良组间的S/D比值、阻力指数值差异显著(P <0.05)。病例组(预后良好组、预后不良组)的S/D比值、阻力指数值均显著高于正常对照组(P <0.05);预后不良组的S/D比值、阻力指数值均显著高于预后良好组(P <0.05)。病例组S/D比值与血管阻力指数值呈显著正相关关系(r=0.475,P <0.001)。ROC曲线分析结果显示,S/D比值、血管阻力指数在诊断预后不良方面的曲线下面积分别为0.989、0.742,两个指标在诊断预后不良方面均差异有统计学意义(P <0.05)。S/D比值在对照组预后不良诊断中的敏感度和特异度分别为100%、93.8%;血管阻力指数在对照组预后不良诊断中的敏感度和特异度分别为45.0%、93.8%。结论 彩色多普勒超声在检测胎儿血流状态的过程中较易操作,在反映胎儿全身血液循环状况中较为全面。
Objective To analyze the relationship between the prognosis of pregnant women with velamentous placenta and ultrasonic parameters of fetal umbilical artery blood flow during prenatal ultrasound.Methods In this retrospective study,105 pregnant women who delivered in our hospital from January 2019 to December 2021 and were diagnosed with velamentous placenta were included in the case group.According to pregnancy outcome,the patients were divided into good prognosis group(65 cases)and poor prognosis group(40 cases).Forty pregnant women with non-velamentous placenta who delivered in our hospital during the same period and had normal pregnancy and good pregnancy outcome by prenatal ultrasound examination were selected as the normal control group.The ratio of peak systolic flow rate to end diastolic flow rate(S/D value)and vascular resistance index of fetal umbilical artery were obtained by pulse Doppler ultrasonography.The ultrasound images of normal placenta and velamentous placenta were analyzed.The prenatal ultrasonic parameters of fetal umbilical artery blood flow(S/D value,vascular resistance index)were compared among all groups.The correlation between S/D ratio and vascular resistance index was analyzed.The diagnostic value of prenatal umbilical artery flow ultrasound parameters for poor prognosis was analyzed,the regions under ROC curve were calculated,and the diagnostic efficacy of each index was calculated.Results There were significant differences in S/D ratio and resistance index between normal control group,good prognosis group and poor prognosis group(P<0.05).The S/D ratio and resistance index of the case group(good prognosis group and poor prognosis group)were significantly higher than those of the control group(P<0.05);The S/D ratio and resistance index in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).There was a significant positive correlation between S/D ratio and vascular resistance index(R=0.475,P<0.001).ROC curve analysis showed that the area und
作者
曹君玲
金甜
夏敏玲
CAO Junling;JIN Tian;XIA Minling(Department of Ultrasound Medicine,Guangzhou Huadu Maternal and Child Health Hospital(Huzhong hospital),Guangzhou 510800,China)
出处
《医学影像学杂志》
2022年第10期1786-1789,共4页
Journal of Medical Imaging
关键词
脐动脉
血流动力学
帆状胎盘
孕妇
超声检查
Umbilical artery
Hemodynamics
Velamentous placenta
Pregnant women
Prenatal ultrasound
