经阴道二维及三维超声对体外受精-胚胎移植子宫内膜容受性的评估价值

目的应用经阴道二维及三维超声检测子宫内膜厚度、容积和内膜及内膜下血流,比较各参数对体外受精-胚胎移植（IVF-ET）中子宫内膜容受性的评估价值。 方法应用经阴道二维及三维超声,对120例接受IVF-ET的不孕症患者于控制性超排卵（COH）周期人绒毛膜促性腺激素（HCG）注射日进行子宫内膜厚度、内膜容积、内膜及内膜下血流搏动指数（pulse index,PI）、阻力指数（resistance index,RI）、收缩期与舒张期比值（S/D）、内膜及内膜下区域的血管化指数（VI）、血流指数（FI）、血管化血流指数（VFI）测定,根据妊娠结果分为妊娠组与未妊娠组,比较两组之间各参数的差异。 结果120例患者临床妊娠39例,妊娠率为32.5%。两组间子宫内膜厚度、内膜容积差异无统计学意义（P>0.05）,子宫内膜厚度与内膜容积预测妊娠的ROC曲线下面积分别为0.584和0.557;妊娠组内膜及内膜下血流的PI、RI、S/D均明显低于非妊娠组,两组间比较差异均具有统计学意义（Z?＝?-3.811、-3.097、-2.071,P?＝?0.001、0.001、0.038）;内膜及内膜下血流PI、RI、S/D预测妊娠的ROC曲线下面积分别为0.652、0.611、0.612;妊娠组内膜及内膜下VI、FI、VFI参数均高于非妊娠组,两组间比较差异有统计学意义（Z?＝?-1.970、-2.698、-1.981,P?＝?0.490、0.007、0.048;Z?＝?-2.098、-2.090、-2.115,P?＝?0.036、0.037、0.034）。内膜及内膜下VI、FI、VFI预测妊娠的ROC曲线下面积分别为0.729、0.670、0.655及0.720、0.715、0.617。 结论经阴道二维及三维超声可用于评价子宫内膜容受性、预测IVF-ET结局,二维及三维血流参数比较,内膜及内膜下容积血流参数VI对妊娠结果有一定的预测价值。     

经阴道超声检测激素替代周期子宫内膜血流参数对胚胎移植妊娠结局的评估价值

目的:探讨经阴道超声检测激素替代周期胚胎移植中内膜转化日子宫内膜厚度、子宫内膜血流等参数对妊娠结局的评估价值。方法:选择100例于激素替代周期行冻融胚胎移植的不孕症患者,根据妊娠结果分为妊娠组(n=60)与未妊娠组(n=40)。比较两组子宫内膜转化日的子宫内膜厚度、内膜血流搏动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、收缩期峰值流速与舒张末期流速比值(systolic-diastolic ratio,S/D)等参数。结果:两组内膜转化日的雌二醇(estradiol,E2)、黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle stimulation hormone,FSH)水平,优质胚胎数及子宫内膜厚度差异均无统计学意义。与未妊娠组比较,妊娠组内膜PI、RI、S/D等血流动力学参数明显降低(P<0.05)。转化日子宫内膜厚度<8 mm者妊娠率低于子宫内膜厚度≥8 mm者(P<0.05)。妊娠组转化日内膜S/D>3者的比例低于非妊娠组(P<0.05)。结论:经阴道超声检测子宫内膜血流参数,有助于预测激素替代周期胚胎移植的妊娠结局。     

经阴道三维超声在冻融胚胎解冻移植时机选择中的运用价值

目的评价经阴道三维（3D）彩色多普勒超声测定子宫内膜的形态、厚度、容积、内膜及内膜下血流指数预测子宫内膜容受性对选择冻胚解冻移植（FET）时机的作用。方法对110例行FET的患者移植日子宫内膜的形态、厚度、容积、内膜及内膜下血流分型及血流指数进行经阴道三维超声测定。根据临床妊娠与否分为两组,比较上述指标在两组之间有无差异。结果110例患者中临床妊娠44例,临床妊娠率为40％,妊娠组与未妊娠组间虽子宫内膜的厚度、容积差异无统计学意义（P〉0．05）,但子宫内膜容积〈2．0ml的4例患者,无一例妊娠。妊娠组与未妊娠组间子宫内膜形态、内膜及内膜下血流分型差异有统计学意义（P〈0．05）,妊娠组子宫内膜S／D、PI、RI低于未妊娠组,差异有统计学意义（P〈0．05）。结论通过阴道三维彩色多普勒超声测定子宫内膜形态、容积、内膜及内膜下血流分型、血流动力学参数可以预测子宫内膜容受性,对临床选择FET移植时机有指导价值。     

彩色超声多普勒评价子宫内膜容受性的价值

目的 探讨彩色超声多普勒检测子宫内膜血流在评价体外受精-胚胎移植（IVF-ET）中子宫内膜容受性的价值。 方法 对218例进行体外受精一胚胎移植的患者，在HCG日行经阴道彩色多普勒超声检查，测量子宫动脉和黏膜下血流参数及黏膜下血流分型。按妊娠与否分为两组，比较两组问血流参数的差异。 结果 子宫动脉血流参数在两组间无统计学差异；黏膜下血流参数中，妊娠组RI和PI明显低于非妊娠组的，P〈0．05。 结论 HCGEl子宫内膜血流参数（RI，PI）和子宫内膜血流类型可能有助于评价子宫内膜容受性，预测妊娠结局。     

IVF-ET患者鲜胚移植周期子宫内膜容受性超声参数与妊娠结局的关联性研究

目的 探究体外受精-胚胎移植(IVF-ET)患者鲜胚移植周期子宫内膜容受性超声参数与妊娠结局的关联性。方法 选择2020年7月至2023年1月在邯郸市中心医院就诊的98例IVF-ET患者,根据患者移植术后12~14d妊娠结局将研究对象分为妊娠组59例和非妊娠组39例。比较两组患者一般资料;在移植当天通过三维重建技术比较两组患者子宫内膜容积、血管指数(VI)、血流指数(FI)、血管血流指数(VFI)以及子宫内膜下血流参数;受试者操作特性曲线(ROC)分析各子宫内膜容受性超声参数对妊娠结局的预测价值。结果 两组患者子宫内膜厚度、容积及子宫内膜形态分型无显著差异(P>0.05);妊娠组患者子宫内膜下S/D、PI、RI显著低于非妊娠组(P<0.05),而子宫内膜和子宫内膜下FI、VI、VFI均显著高于非妊娠组(P<0.05);患者子宫内膜下PI、S/D、RI、FI、VI、VFI和子宫内膜FI、VI、VFI以及联合检测的ROC曲线下面积(AUC)分别为0.796、0.736、0.617、0.735、0.711、0.717、0.780、0.611、0.725和0.978(P<0.05)。结论 IVF-ET患者子宫内膜下S/D、PI、VI、FI、VFI与子宫内膜VI、VFI均可预测患者妊娠结局,其中联合检测对患者妊娠结局的预测价值最高。     

Doppler examination of uteroplacental circulation in early pregnancy: Can it predict adverse outcome?

PURPOSE: To determine whether spectral Doppler measurements obtained from bilateral uterine, arcuate, radial, and spiral arteries in early gestation correlate with adverse pregnancy outcome. METHODS: One hundred five pregnant women underwent transvaginal Doppler sonographic examination of uteroplacental circulation at 6-12 weeks' gestation. Resistance index (RI) and pulsatility index (PI) of bilateral uterine, arcuate, radial, and spiral arteries were measured. Diameters of gestational sac (GS) and yolk sac, crown-rump length (CRL), GS-CRL difference, and GS/CRL ratio were also recorded. Correlation was made with pregnancy outcome. RESULTS: Sixteen women developed adverse pregnancy outcome. In these women, right uterine artery PI and RI were significantly higher than in women with normal obstetrical outcome. Spiral artery PI and RI values were also higher, but the difference was not statistically significant. GS-CRL difference, GS/CRL ratio, and yolk sac diameters were significantly lower in this group. CONCLUSION: Transvaginal Doppler examination can detect hemodynamic changes in uteroplacental circulation associated with subsequent adverse pregnancy outcome.     

高危妊娠胎儿肾动脉、大脑中动脉搏动指数比值预测胎儿缺氧

目的 应用彩色多普勒超声技术检测胎儿大脑中动脉(MCA)和肾动脉(RA)血流动力学指标,探讨高危妊娠胎儿RA和MCA的搏动指数比值预测胎儿宫内缺氧的临床应用价值.方法 选取晚期正常妊娠孕妇95例,晚期高危妊娠孕50例,检测两组胎儿MCA和RA的血管收缩期峰值速度(S)与舒张末期流速(D)比值、阻力指数(RI)及搏动指数(PI),同时计算两组RA与MCA的PI比值,并将以上检测值与围产儿缺氧指标进行比较.结果 高危组胎儿MCA脉各阻抗指标均低于正常妊娠组(P＜0.01);RA各阻抗指标均高于正常妊娠组(其中PI、RI值P＜0.01,S/D值P＜0.05);RA和MCA搏动指数比值高于正常组(P＜0.01).以PIRA/MCA＞1.50提示胎儿宫内缺氧的敏感性和特异性分别为86.0%和91.5%.结论 胎儿RA和MCA的搏动指数比值预测胎儿缺氧具有较高的敏感性和特异性.     

The pattern of changes in ovarian stromal and uterine artery blood flow velocities during in vitro fertilization treatment and its relationship with outcome of the cycle.

OBJECTIVES: To assess the effect of short-term (2-3 weeks) pituitary suppression and controlled ovarian stimulation on ovarian and uterine artery Doppler measurements during the in vitro fertilization (IVF) treatment cycle and to compare the pattern of these changes between conception and non-conception cycles as well as between patients with normal and those with polycystic ovaries. DESIGN: Prospective observational study of women undergoing IVF treatment. SUBJECTS: Women using the long-treatment buserelin protocol who did not have uterine fibroids, ovarian cysts or endometrioma. METHODS: Serial transvaginal color and pulsed Doppler measurements of ovarian stromal and uterine artery blood flow velocity were carried out in the early follicular phase of the menstrual cycle, on the day of pituitary suppression and on the day of administration of human chorionic gonadotropin (hCG). The main outcome measures were the ovarian stromal and uterine artery blood flow peak systolic velocity (PSV) and pulsatility index (PI). RESULTS: A total of 105 patients were recruited but six patients were excluded from the analysis because they had only one stage of the measurements performed. There was a significant decline in mean ovarian stromal artery PSV after 2-3 weeks of gonadotropin releasing hormone (GnRH) agonist therapy but no effect on ovarian stromal artery PI. The mean uterine artery PSV or PI did not change significantly after 2-3 weeks of GnRH agonist therapy. There was a significantly higher mean ovarian stromal artery PSV in conception cycles compared to non-conception cycles in the early follicular phase and on the day of pituitary suppression, but not on the day of hCG administration. There were no differences between conception and non-conception cycles in the mean uterine artery PSV or PI. Women with polycystic ovaries had a higher mean ovarian artery PSV on all the three occasions of measurement. CONCLUSION: These data suggest that assessment of ovarian blood flow before commencement of gonadotropin stimulation may play a role in assessing cycles likely to result in pregnancy.     

Blood flow velocity in the uterine and ovarian arteries during the normal menstrual cycle.

Twelve healthy women with regular menstrual cycles were examined with a combination of two-dimensional real-time ultrasound and color and spectral Doppler techniques on cycle days 4 and 8 and daily from cycle day 12 until follicular rupture, then days + 1, +2, +5, +7 and +12 after follicular rupture. The uterine and subendometrial arteries, arteries in the ovarian stroma and hilum, in the wall of the largest follicle of each ovary, and in the wall of the corpus luteum were examined. The pulsatility index and the time-averaged maximum velocity were calculated. In the uterine arteries the pulsatility index was highest on day + 2, after which it decreased successively to its lowest value, whereas the time-averaged maximum velocity reached its highest value on day + 12. Similar changes were observed in the subendometrial arteries. In the non-dominant ovary, neither the pulsatility index nor the time-averaged maximum velocity manifested any consistent changes during the cycle. In the dominant ovary, the time-averaged maximum velocity increased and the pulsatility index decreased after follicular rupture, being significantly higher and lower, respectively, in the luteal than in the follicular phase. These changes were seen in the ovarian hilum, stroma and follicular wall, but were most obvious in the wall of the dominant follicle and of the corpus luteum. We conclude that the blood circulation in the uterus and in the dominant ovary changes considerably during the menstrual cycle, whereas that in the non-dominant ovary shows no unequivocal changes.     

子痫前期患者子宫动脉多普勒与血清chemerin的变化及意义

目的:讨论妊娠期高血压孕妇和正常妊娠妇女妊娠早、中、晚期子宫动脉血流变化及血清chemerin变化的规律及意义。方法:选取潍坊市妇幼保健院系统产前检查的孕妇共300例作为研究对象,分别于妊娠14周、24周、34周收集和测量两组孕妇的血液样本和子宫动脉多普勒信息。比较两组孕妇血清chemerin浓度,子宫动脉舒张末期流速(S/D)、搏动指数(PI)、阻力指数(RI)。结果:1)子痫前期患者血清中chemerin浓度明显高于对照组(P<0.05),且重度子痫前期组明显高于轻度子痫前期组(P<0.05)。2)子宫动脉血流动态变化:正常妊娠组孕妇随妊娠进展,子宫动脉RI、PI、S/D 3项指标逐渐降低,妊娠早、中、晚期分别比较,均有统计学差异(P<0.01)。子痫前期组孕妇子宫动脉RI、PI、S/D 3项指标以孕晚期最高,妊娠早、中、晚期分别比较,均有统计学差异(P<0.01)。子痫前期组孕妇妊娠中、晚期子宫动脉3项指标均高于正常妊娠组,有统计学差异(P<0.01)。3)子痫前期患者血清中chemerin浓度在孕早期与子宫动脉血流无明显相关性,在妊娠中晚期呈明显正相关。结论:随着妊娠进展,子痫前期患者血清中chemerin浓度逐渐升高,正常妊娠妇女子宫动脉的血流阻力逐渐下降;而子痫前期组孕妇随妊娠进展子宫动脉的血流阻力明显升高。两者共同参与妊娠期高血压的发病。     

Uterine artery impedance to blood flow on the day of embryo transfer does not predict obstetric outcome.

OBJECTIVE: To evaluate the influence of uterine artery impedance to blood flow on the day of embryo transfer for prediction of early pregnancy loss and obstetric outcome. METHODS: The uterine artery pulsatility index (PI) and resistance index (RI) were evaluated prospectively by transvaginal Doppler in 102 infertile women, who conceived as the result of fresh or frozen embryo transfer. Uterine artery impedance to blood flow was compared to the obstetric outcome. RESULTS: The 111 treatment cycles studied resulted in 31 spontaneous abortions, four ectopic pregnancies, and 76 deliveries. There were no differences in uterine artery PI and RI (mean +/- SD) between cycles resulting in normal delivery (2.69 +/- 0.71 and 0.88 +/- 0.06) and those resulting in spontaneous abortion (2.71 +/- 0.67 and 0.88 +/- 0.05) or ectopic pregnancy (2.36 +/- 0.54 and 0.85 +/- 0.06). There were no differences in PI and RI between uncomplicated singleton pregnancies (2.74 +/- 0.78 and 0.88 +/- 0.06) and those developing intra-uterine growth restriction (IUGR), pregnancy-induced hypertension (PIH), or preterm birth (2.54 +/- 0.47 and 0.87 +/- 0.04, pooled data). CONCLUSIONS: Uterine artery PI and RI on the day of embryo transfer were unrelated to the risk of the pregnancy ending in spontaneous abortion or ectopic pregnancy. These values were of no value in the prediction of IUGR, PIH or preterm birth.     

Effects of physiotherapeutic TENS in a woman with unexplained infertility

Unexplained infertility (UI) is a difficult diagnosis in the field of obstetrics and gynaecology. This report describes TENS treatment as an adjunct therapy for a 30-year-old woman with long-standing UI who was scheduled to undergo ovarian stimulation for in vitro fertilization (IVF) and embryo transfer. She had three unsuccessful intrauterine insemination treatments. Her last IVF treatment also failed. The treatment consisted of burst-TENS for seven sessions, which was applied daily from the second day of induction of ovulation (IO) to hCG administration. The transvaginal ultrasonography with pulsed Doppler curves was performed to measure the uterine artery impedance indices of Pulsatility Index (PI) and Resistance Index (RI). Before TENS application, on the first day of IO, the PI and RI for right side uterine artery were 3.96 and 0.96, respectively. For left uterine artery, the PI and RI were 6.92 and 1, respectively. After treatment with TENS, on the day of hCG administration, the PI and RI for right side uterine artery were 3.39 and 0.90, respectively. On the left side, they were PI=2.62 and RI=0.86. IVF was performed and on the day of oocytes collection, 22 oocytes were collected and inseminated. Fertilization was confirmed 16 hours after insemination by visualization of 2 pronuclei. A singleton pregnancy was achieved by the presence of a fetal sac during an ultrasound examination. It is concluded that the addition of TENS resulted in remarkable reduction of uterine artery PI and RI and a successful pregnancy after IVF for this woman with UI.     

彩色多普勒血流动力学指标预测胎儿缺氧及酸中毒的价值

目的： 评价血液动力学指标预测胎儿缺氧及酸中毒的价值。方法： 用彩色多普勒超声检测 ５４ 例正常晚 期妊娠 （正常组） 和 ３６ 例高危妊娠 （高危组） 妇女子宫动脉 （ＵｔＡ） 和胎儿脐动脉 （Ｕｍ Ａ）、大脑中动脉（Ｍ ＣＡ）、肾动脉 （ＲＡ） 的血流速度波型 （ＦＶＷ ｓ）, 并且测定高危组脐动脉血气。结果： 高危组ＵｔＡ、Ｕｍ Ａ、ＲＡ 的阻力指数 （ＲＩ） 搏动指数 （ＰＩ） 及收缩期最大血流速度与舒张末期血流速度的比值 （Ｓ／Ｄ） 均高于正常组, 而Ｍ ＣＡ的ＰＩ及Ｓ／Ｄ 值均明显低于正常组 （Ｐ＜ ００５）。与Ｕｍ Ａ 氧分压 （ＰＯ２） ＞ ２５ｋＰａ 的高危妊娠病例比较, Ｕｍ Ａ ＰＯ２＜２５ ｋＰａ 者ＵｔＡ 的Ｓ／Ｄ 值, Ｕｍ Ａ 的ＰＩ, Ｓ／Ｄ 值以及ＲＡ 的ＲＩ、ＰＩ、Ｓ／Ｄ 值均明显增高, Ｍ ＣＡ 的ＰＩ明显降低 （Ｐ＜００５）。Ｕｍ Ａ 及ＲＡ 的ＰＩ与Ｕｍ Ａ ＰＯ２ 的ｐＨ 值呈负相关, 与二氧化碳分压 （ＰＣＯ２） 呈正相关, Ｍ ＣＡ 的ＰＩ与Ｕｍ Ａ的 ｐＨ、ＰＯ２ 呈正相关, 与ＰＣＯ２ 呈负相关。结论： 高危妊娠胎儿缺氧时, Ｍ ＣＡ 血流阻力降低, 而周围血管, 特别是肾血管血流阻力明显升高。胎儿血液动力学变化与缺氧及酸碱平衡失     

Color Doppler imaging of the uteroplacental circulation in the middle trimester: observations on the development of a low-resistance circulation.

We aimed to study the changes in the flow dynamics of the uteroplacental and umbilical circulations in the middle trimester of normal pregnancy, and establish normal ranges for indices of the Doppler flow velocity waveforms (FVWs) from both circulations at 14, 18 and 24 weeks. A longitudinal study was conducted with the use of color Doppler imaging to localize both uterine arteries and umbilical arteries and obtain FVWs from 106 healthy nulliparous women with a singleton pregnancy. Of these, 70 did not have a complicated pregnancy outcome, defined as hypertension, growth retardation, preterm delivery or perinatal death. We measured the resistance index (RI), pulsatility index (PI), systolic/diastolic (S/D) ratio and presence of early diastolic notching in both uterine arteries, and RI, PI and S/D in one umbilical artery. The results showed a fall in all measured indices of blood flow impedance in the uteroplacental and umbilical circulations and a marked reduction in the incidence of the early diastolic notch in the uterine artery FVWs during the mid-trimester. Our conclusion was that color Doppler imaging allows for the accurate localization of both uterine and umbilical arteries. Doppler FVWs then obtained confirm the development of the low-resistance uteroplacental and umbilical circulations in the mid-trimester. Diastolic notching is common at 14 weeks in normal pregnancy but uncommon at 24 weeks.     

Assessment of changes in endometrial and subendometrial volume and vascularity during the normal menstrual cycle using three-dimensional power Doppler ultrasound.

OBJECTIVES: To describe changes in endometrial and subendometrial volume and vascularity during the normal menstrual cycle using three-dimensional (3D) power Doppler ultrasonography. METHODS: Fourteen healthy volunteers, 24-44 years old with regular menstrual cycles, underwent serial transvaginal 3D power Doppler ultrasound examinations of the uterus on cycle day 2, 3 or 4, then daily from cycle day 9 until follicular rupture and 1, 2, 5, 7 and 12 days after follicular rupture. Endometrial and subendometrial volume (cm3), vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were calculated using the VOCAL (Virtual Organ Computer-aided AnaLysis) software. RESULTS: Endometrial and subendometrial vascularity indices increased throughout the follicular phase, decreased to a nadir 2 days after follicular rupture and then increased again during the luteal phase. Endometrial and subendometrial volume increased rapidly during the follicular phase and then remained almost unchanged during the luteal phase. CONCLUSIONS: Substantial changes occur in endometrial volume and vascularization during the normal menstrual cycle. There is the potential for 3D power Doppler ultrasonography to become a useful tool for assessing pathological changes associated with female subfertility and abnormal uterine bleeding.     

Evaluation of endometrial receptivity during in-vitro fertilization using three-dimensional power Doppler ultrasound.

OBJECTIVE: To compare sonographic endometrial characteristics in in-vitro fertilization (IVF) cycles between women who conceive and those who do not. METHODS: Thirty-five women undergoing IVF treatment participated in the study. Using three-dimensional (3D) power Doppler ultrasound, we assessed endometrial patterns, volume and vascularization, after follicle stimulating hormone (FSH) stimulation but before human chorionic gonadotropin (hCG) administration (referred to hereafter as 'after FSH stimulation') and again on the day of oocyte retrieval. RESULTS: The pregnancy rate was 37% (13/35). After FSH stimulation, 29 of the 35 women had a triple-line endometrial pattern, compared with five out of 35 on the day of oocyte retrieval. In those who had a triple-line pattern after FSH stimulation the pregnancy rate was 44.8% (13/29) and it was 0% (0/6) in those with a homogeneous pattern (chi-square test, P = 0.039). If a triple-line pattern was present on the day of oocyte retrieval the pregnancy rate was 80.0% (4/5), whereas if the pattern was homogeneous the pregnancy rate was 30.0% (9/30) (P = 0.032). There were no differences between those who conceived and those who did not in endometrial thickness, volume or vascularization on either day examined. Endometrial volume decreased significantly after hCG injection in women who conceived, but not in those who did not conceive. In both groups endometrial and subendometrial vascularization decreased after hCG injection, while the endometrial thickness remained unchanged. CONCLUSIONS: The existence of a homogeneous endometrial pattern after FSH stimulation seems to be a prognostic sign of an adverse outcome in IVF, while a triple-line pattern after FSH stimulation and a decrease in endometrial volume appear to be associated with conception.     

TCD检测系统性红斑狼疮患者脑血流动力学变化

目的：了解系统性红斑疮患者脑血流动力学状况,方法;利用经颅我镨勒（ＴＣＤ）测定纤斑疮患者和健康对照组脑血管收缩峰速度（Ｖｓ）、舒张期血流速度（Ｖｄ）、平均血流速度（Ｖｍ）、收缩／舒张比值（Ｓ／Ｄ）、血管搏动指数（ＰＩ）、阻力指数ＲＩ）。结果：红斑狼疮患者无Ｖｓ、Ｖｍ是否升高,各脑血管Ｖｄ均较对照组显著增快（Ｐ〈０．０１）,ＰＩ、ＲＩ显著降低（Ｐ〈０．０１）,突出表现为低的ＴＣＤ频谱改变。结论：红斑     

彩色多普勒监测胎儿腹主动脉血流预测胎儿宫内状况

运用彩色多普勒监测正常妊娠、妊高征、合并ＩＵＧＲ的妊高征胎儿的腹主动脉血流，计测血流Ｓ／Ｄ值、ＰＩ值、ＲＩ值。结果表明，妊高征组（合并或不合并ＩＵＧＲ）胎儿腹主动脉血流Ｓ／Ｄ值大于４、ＰＩ值大于１．８、ＲＩ值大于０．８时，围产儿结局异常占５０％。当血流阻力指标异常升高时，应考虑胎儿窘迫或ＩＵＧＲ的发生。当异常波形出现时，说明血流阻力指标升高，血流量减小。胎儿宫内状况差，预后不良的发生率高。该监测方法可及早发现异常，及时处理、降低围产儿死亡率。     

低分子肝素钙治疗妊娠期肝内胆汁淤积症对胎儿脐血流及围生儿的影响

[目的]探讨低分子肝素钙(1ow molecular weight heparin calcium,LM-WHC)对妊娠期肝内胆汁淤积症患者胎儿脐血流及围生儿的影响.[方法]本院收治的116例妊娠期肝内胆汁淤积症患者,随机分为对照组与观察组,对照组采用口服熊去氧胆酸[15 mg/(kg·d)],静滴还原性谷胱甘肽(1....     

妊娠期高血压病胎儿肾动脉和大脑中动脉阻力指标比值预测胎儿缺氧

目的探讨妊娠期高血压疾病胎儿肾动脉和大脑中动脉阻力指标比值预测胎儿宫内缺氧的价值。方法应用彩色多普勒超声检测65例正常妊娠和46例妊娠期高血压疾病胎儿肾动脉（RA）、大脑中动脉（MCA）阻力指数（RI）、搏动指数（PI）及S／D值，计算RA与MCA各指标比值。结果妊娠期高血压疾病组胎儿RA阻力指标均明显高于正常对照组（P〈0．01），MCA阻力指标均低于正常对照组（P〈0．05），RA和MCA阻力指标比值高于正常组（P〈0．01）。以（RIRA，MCA、）〉1．11，（PIRA，MCA）〉1．30，（SRA／DRA）／（SMCA／DRA）〉1．44提示胎儿宫内缺氧的敏感性、特异性分别为89％、92％。结论胎儿肾动脉和大脑中动脉阻力指标比值预测胎儿宫内缺氧具有较高的敏感性和特异性。