脐动脉血流速率检测在胎儿监护中的作用

目的评价脐动脉收缩期最大血流速度（Ｓ）与舒张末期血流速度（Ｄ）的比值（Ｓ／Ｄ值）在胎儿监护中的作用。方法对１２７例高危孕妇及１４５例低危孕妇进行脐动脉Ｓ／Ｄ值测定，并追踪观察胎儿妊娠结局。结果高危妊娠组Ｓ／Ｄ值异常阳性率及胎儿窘迫、新生儿窒息的发生率（分别为３１．５０％、４７．９２％、１４．５８％）明显高于低危妊娠组（分别为５．５２％、１２．５９％、１．３４％））（Ｐ＜０．０１）。该项检测对胎儿生长迟缓（ＩＵＧＲ）及妊高征有较高的敏感性（分别为８０％和５０％）。结论脐动脉Ｓ／Ｄ值异常提示子宫胎盘血流灌注下降，血管阻力增加，可作为胎儿监护的一项有效指标，但需与Ｂ超等检测手段联合应用，使诊断结果更完善。

Effect of Determination of Umbilical Artery Flow Velocity in Fetal Monitoring

Objective To evaluate the value of ratio of umbilical arterial flow velocity during systolic to diastolic period (S/D) in fetal monitoring.Method Detemination of S/D was performed in 127 cases of high risk and 145 cases of low risk pregnant women with 33￣42 gestatinal weeks and the pregancy outcome were followed up.Results The abnormal rate of S/D and occurence rate of fetal distress and neonatal asphyxia in the high risk pregnant women(31.50%, 47.92%, 14.58% respectively) were higher than those in the low risk pregnant women (5.52%,12.95%,1.34% respectively)(P<0.01). This technique had a higher sensitivity to detect fetal growth retardation and pregnancy induce hypertension (80% and 50% respectively). Conclusions The abnormal umbilical arterial S/D ratio frequently indicates decrease of flow perfusion in uterus placenta, increase of vascular resistance, therefore, it may be effective index in fetal monitoring ,but it is necessary to combine with B model ultrasonic imaging in order to obtain better diagnostic result.