脑-胎盘率检测对反复无应激试验无反应型孕妇的临床意义

目的探讨对反复无应激试验（no-stress test,NST）无反应型孕妇进行脑-胎盘率（PIMCA/PIUA）检测的临床意义。方法运用彩色多普勒超声检测200例孕37~41周反复NST无反应型孕妇的胎儿大脑中动脉（MCA）和脐动脉（UA）的血流阻力指标（包括S/D、RI、PI）、计算各自的脑-胎盘率,并根据胎儿有否不良结局分为两组进行比较分析。结果不良结局组测得的MCA各阻力指标明显低于正常组（P〈0.01）,UA各阻力指标明显高于正常组（P〈0.05）,脑-胎盘率明显低于正常组（P〈0.01）。在PIMCA/PIUA〈1组,胎儿不良结局发生率明显高于PIMCA/PIUA〉1组（P〈0.01）;以PIMCA/PIUA〈1预测胎儿不良结局的敏感性为25.7%,特异性为98.2%。结论脑-胎盘率检测对于胎儿不良结局的预测具有不错的临床价值,当反复NST无反应型孕妇（无其他高危因素）的脑-胎盘率〈1时须警惕胎儿不良结局的发生。

Clinical value of detecting fetal cerebroplacental ratio in pregnancies with repeated abnormity of non-stress test

Objective To exploring the clinical value of detecting fetal cerebroplacental ratio in pregnancies with repeated abnormity of non-stress test.Methods 200 pregnant women during 37～41 gestational weeks with repeatedabnormity of non-stress test(NST)received blood flow resistant parameters(include S/D,RI,PI)measuring of the fetal MCA and UA.Fetal cerebroplacental ratio was calculated.Women were divided into normal group and unhealthy group according to fetus outcomes.Results The resistant parameters of fetal MCA and the cerebroplacental ratio in the unhealthy group were significantly lower than those of the normal group(P<0.01)while the resistant parameters of fetal UA were significantly higher than those of the normal group(P<0.05).Rate of unhealthy outcomes in PIMCA/PIUA <1 group was significantly higher than that in PIMCA/PIUA >1 group(P<0.01);Using PIMCA/PIUA<1 as the cutoff,the sensitivity and specificity in predicting fetal unhealthy outcomes is 25.7% and 98.2%.Conclusions The fetal cerebroplacental ratio detection has a satisfactory clinical value in predicting the fetal unhealthy outcomes.We should keep watchful eyes on fetus when the PIMCA/PIUA is lower than 1 in pregnancies with repeated abnormity of non-stress test.