脐动脉血流检测在双胎妊娠中的应用

目的　探讨检测脐动脉血流收缩期峰值速度与舒张末期最低流速比值 (S/D )和搏动指数(PI)对双胎围产儿预后的预测价值。方法　对 77例双胎应用脉冲多普勒超声行脐动脉血流检测 ,按S/D和PI值分为血流正常组和异常组 ,分别比较S/D及PI值正常组和异常组的围产儿预后 ,并比较单卵双胎和双卵双胎脐动脉血流S/D和PI值异常的发生率。结果　脐动脉血流S/D值异常组中围产儿预后不良的发生率显著高于正常组 ,其中异常组中胎儿畸形和小于胎龄儿的发生率显著高于正常组 (P <0 .0 5 )。脐动脉血流PI值异常组中围产儿预后不良的发生率显著高于正常组 ,其中异常组中小于胎龄儿的发生率显著高于正常组 (P <0 .0 5 )。单卵双胎的脐动脉血流S/D、PI值异常的发生率显著高于双卵双胎 (P <0 .0 5 )。结论　脐动脉血流S/D和PI值对双胎围产儿预后有预测价值 ,尤其对小于胎龄儿和胎儿先天性畸形有重要的预测价值。

Use of umbilical artery Doppler velocity in management of twin pregnancies

Objective To discuss the value of minimum systolic and diastolic peak velocity ratio(S/D) and pulse index(PI) of the umbilical artery of pregnant twins in predicting perinatal outcome.Methods Pulsed Doppler measurements of the umbilical artery were conducted in 77 cases of twin pregnancise. Perinatal outcome was compared between normal and abnormal umbilical artery S/D,PI group respectively. The rates of abnormal umbilical artery S/D,PI in monochorionic and dichorionicdich were compared. Results The rates of adverse perinatal outcome,small for gestational age(SGA),structural malformation in abnormal umbilical artery S/D group were significantly higher than those in normal umbilical artery S/D group ( P < 0.05 ). The rates of adverse perinatal outcome,SGA in abnormal umbilical artery PI group were significantly higher than those in normal umbilical artery PI group ( P < 0.05 ). The rates of abnormal umbilical artery S/D and PI in monochorionic were significantly higher than those in dichorionicdich ( P < 0.05 ). Conclusions The value of pulsed Doppler evaluation of the umbilical artery of twins in predicting prenatal outcome is proved,especially in predicting SGA and structural malformation.