摘要
目的 分析多普勒超声检测联合早孕期子宫动脉血流对高龄孕妇的诊断价值及与胎儿窘迫的相关性。方法 选取2021年1月—2023年1月嘉兴市秀洲区妇幼保健院收治的80例高龄孕妇为研究对象,检测后将发生胎儿窘迫的40例高龄孕妇作为研究组;未发生胎儿窘迫的40例健康高龄孕妇作为对照组,均实施多普勒超声检测。对比两组孕妇的大脑中动脉(middle cerebral artery, MCA)、脐动脉(umbilical artery, UA)、子宫动脉(uterine artery, UtA)的血流指标及静脉导管(ductus venous, DV)中的a波反向情况,分析子宫动脉血流指标与发生胎儿窘迫之间的相关性,ROC曲线分析搏动指数(pulsatility index, PI)、阻力指数(resistance index, RI)及收缩末期最大血流速度与舒张末期最大血流速度之比(S/D)对高龄孕妇发生胎儿窘迫的诊断价值。结果 与对照组比较,研究组胎儿MCA的PI、RI及S/D值有所下降,差异有统计学意义(P<0.05)。对照组孕妇未出现三尖瓣返流,静脉导管血流频谱未发生a波反向情况;而研究组孕妇经频谱测定发生a波反向有6例,其中,Ⅱ型2例,Ⅲ型4例,且两组孕妇DA的a波反向发生率比较,差异有统计学意义(χ^(2)=6.486,P=0.011)。与对照组比较,研究组胎儿UA的PI、RI及S/D值有所升高,差异有统计学意义(P<0.05)。与对照组比较,研究组孕妇UtA的PI、RI及S/D值表达均有所升高,差异有统计学意义(P<0.05)。与PI、RI及S/D单项诊断相比,三项联合对高龄孕妇发生胎儿窘迫的诊断价值较高(P<0.05)。结论 观察经多普勒超声对高龄孕妇检测后早孕期子宫动脉血流变化情况,且其与发生胎儿窘迫之间有一定的相关性,以提升检测胎儿窘迫的准确性,且三项联合可有效提高诊断高龄孕妇发生胎儿窘迫的临床价值。
Objective To analyze the diagnostic value of Doppler ultrasonography combined with uterine arterial blood flow in early pregnancy in older pregnant women and the correlation of fetal distress in utero.Methods A total of 80 elderly pregnant women admitted to our hospital from January 2021 to January 2023 were selected as the research subjects.After testing,they were divided into 40 elderly pregnant women who experienced fetal distress based on whether they could experience fetal distress.They were included in the study group;Forty healthy elderly pregnant women who did not experience fetal distress in the uterus were selected as the control group and underwent Doppler ultrasound testing.Compare the blood flow indexes of middle cerebral artery(MCA),umbilical artery(UA),uterine artery(UtA)and a-wave reverse in venous catheter(DV)between the two groups,and analyze the correlation between uterine artery blood flow indexes and fetal distress,ROC curve analysis,pulsatility index(PI)The diagnostic value of resistance index(RI),ratio of maximum systolic blood flow velocity to maximum diastolic blood flow velocity(S/D)for fetal distress in elderly pregnant women.Results Compared with the control group,PI,RI and S/D value of MCA in the study group were decreased(P<0.05).There was no tricuspid regurgitation in the control group and no reverse a wave in the venous catheter flow spectrum.In the study group,there were 6 cases of A-wave reversal in pregnant women,including 2 cases of typeⅡand 4 cases of typeⅢ,and the incidence of A-wave reversal of DA between the two groups was statistically different(χ^(2)=6.486,P=0.011).Compared with the control group,the PI,RI and S/D value of fetal UA in the study group were increased(P<0.05).Compared with the control group,the UtA expression of PI,RI and S/D value were increased in the study group(P<0.05).Compared with the single diagnosis of PI,RI and S/D,the combination of PI,RI and S/D had higher diagnostic value for the occurrence of fetal distress in older pregnant women(P<0.05).C
作者
吴兰增
沈志良
鲁秀莉
WU Lan-zeng;SHEN Zhi-liang;LU Xiu-li(Department of Ultrasound,Jiaxiang City Xiuzhou District Maternal and Child Health Hospital,Jiaxing,Zhejiang 314001,China)
出处
《中国妇幼保健》
CAS
2024年第2期359-362,共4页
Maternal and Child Health Care of China
基金
国家卫生健康委“十四五”规划全国重点课题项目(YYWS3776)。
关键词
高龄孕妇
多普勒超声
早孕期
子宫动脉血流
胎儿窘迫
Advanced maternal age
Doppler ultrasound
Early pregnancy
Uterine arterial blood flow
Fetal distress in utero
