胎儿生长受限与脐血流比值及孕妇红细胞压积的关系研究

目的探讨胎儿生长受限与脐血流比值及孕妇红细胞压积的关系。方法选取广州医学院附属深圳沙井人民医院2009年1月至2013年8月诊治的胎儿生长受限孕妇73例为观察组,选取本院同期正常孕妇74例为对照组,均行脐血流比值及孕妇红细胞压积检测,分析两组孕妇的孕期合并症,比较两组孕妇及胎儿的妊娠结局,分析胎儿生长受限与脐血流比值及孕妇红细胞压积的相关性。结果随着孕周的增加,脐血流比值呈现出降低的趋势,但观察组孕妇胎儿脐血流比值在32~42周均明显高于对照组;观察组孕妇妊娠期糖尿病、妊娠期高血压疾病、产后出血、泌尿系统感染、胎盘早剥发生率及剖宫产率明显高于对照组(P0.05);观察组早产、胎儿窘迫、新生儿低体重及新生儿窒息发生率均明显高于对照组(P0.05),胎儿生长受限与脐血流比值、孕妇红细胞压积呈明显的正相关性(P0.05)。结论胎儿生长受限与脐血流比值及孕妇红细胞压积关系密切,血液浓缩与脐血流阻力增加会进一步加剧胎儿生长受限,会直接影响到孕妇及胎儿的妊娠结局。

Research on relationship between fetal growth restriction and umbilical blood flow ratio and maternal hematokrit

Objective To investigate relationship between fetal growth restriction and umbilical blood flow ratio and maternal hematokrit. Methods 73 pregnant women with fetal growth restriction in Shenzhen City Shajing District peopleˊs Hospital Affiliated to Guangzhou Medical College from January 2009 to August 2013 were selected as observation group. 74 normal pregnant women were selected at the same period as control group. Umbilical blood flow ratio and maternal hematokrit of pregnant women were detected. pregnancy complications were analyzed in two groups. Maternal and fetal outcome were compared between two groups. Correlation between fetal growth restriction and umbilical blood flow ratio,maternal hematokrit were analyzed. Results Along with increasing of gestational week,umbilical blood flow ratio showed decreasing trend. Umbilical blood flow ratio at 32 ～ 42 weeks in observation group were significantly higher than control group. Incidence of gestational diabetes,gestational hypertension,cesarean section;postpartum hemorrhage,urinary system infection,and placental abruption in observation group were significantly higher than control group（P〈 0. 05）. Incidence of fetal premature infants;fetal distress;low birth weight;neonatal asphyxia in observation group were significantly higher than control group（P〈 0. 05）. Fetal growth restriction had showed significantly positive correlation with with umbilical blood flow ratio and maternal,hematokcrit（ P〈0. 05）. Conclusion Fetal growth restriction has a close relationship with umbilical blood flow ratio,and maternal hematokrit,blood concentration and umbilical artery blood flow resistance can deteriorate further fetal growth restriction,which will directly affect maternal and fetal outcome.