脉冲多普勒技术测定胎儿脐动脉、子宫动脉血流速度预测新生儿预后

采用脉冲式超声多普勒诊断仪测定了123例足月妊娠脐动脉(UmA)、121例子宫动脉(UtA)血流速度波,以收缩期最大速度与舒张末期最低速度之比(S/D)作为胎盘血管床阻力的测定指标。本实验测得UmA、UtA的S/D的正常参考值分别为<3.0及<2.5。本实验结果表明:UmA及UtA之S/D正常与异常组间,新生儿预后不良均有极显著性差异(P<0.005,<0.01);预测新生儿预后不良两者的敏感度分别为72.7％和27.3％(P<0.05),提示UmA的S/D较UtA的S/D对新生儿预后不良的预测价值更大。

Pulsed--wave Doppler Ultrasouud Evaluation of Flow Velocity waveforms of Fetal Umbilical Artery and Uterine Artery as Predictors of Neonatal Outcome

A pulsed-wave doppler ul-trasound system was used to record arter- ial flow velocity time waveforms from thefetal umbilical artery (UmA) and the bran-ches of the uterine artery (UtA) in theplacental bed in term pregnancies. The sys-tolic-diastolic ratio(S/D)of flow velocity wasmeasured as an index of peripheral resis-tance in the placental bed. The UmA S/Dratio was measured in 123 pregnant womenbetween 37-<42 gestational weeks and theUtA S/D ratio was measured in 121 ofthem simultaneously. The cutoff value ofan abnormal UmA S/D ratio was 3.0 orhigher, and UtA S/D ratio 2.5 or higher.Furthermore, the neonatal poor outcomewas observed more frequently in both theabnormal ratio groups than in both thenormal ratio groups. The sensitivity of theUmA, and UtA S/D ratios to predict anadverse neonatal outcome was 72.7%, 27.3%,respectively. The data showed the abnor-mal UmA S/D and abnormal UtA S/D ra-tios were associated with the neonatal pooroutcome, but the former was the bettertest for screening for adverse neonataloutcome.