脐带绕颈胎儿脐动脉及大脑中动脉超声血流参数的特点及与胎儿宫内窘迫的相关性分析

目的探讨脐带绕颈胎儿脐动脉(UA)及大脑中动脉(MCA)超声血流参数的特点及与胎儿宫内窘迫的相关性。方法将106例胎儿脐带绕颈孕妇、100例正常孕妇分别纳入脐带绕颈组、非脐带绕颈组。根据不同孕周、是否发生胎儿宫内窘迫对脐带绕颈组孕妇进行再次分组,分别为28~36周组(52例)、≥37周组(54例);宫内窘迫组(28例)、非宫内窘迫组(78例)。比较各组UA、MCA的RI、PI、S/D。分析UA、MCA超声血流参数与胎儿宫内窘迫的相关性。结果脐带绕颈组UA、MCA的RI、PI、S/D均高于非脐带绕颈组(P<0.05)。28~36周组UA、MCA的RI、PI、S/D均低于≥37周组(P<0.05)。宫内窘迫组UA的PI、S/D高于非宫内窘迫组,MCA的RI、PI、S/D高于非宫内窘迫组(P<0.05)。Logistic回归分析结果显示,UA、MCA的PI、RI、S/D与胎儿宫内窘迫存在明显相关性(P<0.05)。结论脐带绕颈胎儿UA、MCA超声血流参数(RI、PI、S/D)均高于非脐带绕颈胎儿,且孕晚期更为突出,UA及MCA的RI、PI、S/D与胎儿宫内窘迫呈高度相关。

Analysis of characteristics of ultrasound blood flow parameters of umbilical artery and middle cerebral artery in fetuses with umbilical cord around neck and their correlation with fetal distress

Objective To explore the characteristics of ultrasound blood flow parameters of umbilical artery(UA)and middle cerebral artery(MCA)in fetuses with umbilical cord around neck and their correlation with fetal distress.Methods A total of 106 pregnant women with umbilical cord around neck and 100 normal pregnant women were included in umbilical cord around neck group and non-umbilical cord around neck group respectively.According to different gestational weeks and fetal distress,pregnant women in the umbilical cord around neck group were divided into 28-36 weeks group(52 cases),≥37 weeks group(54 cases);intrauterine distress group(28 cases)and non-intrauterine distress group(78 cases)respectively.The RI,PI and S/D of UA and MCA among groups were compared.The correlation between ultrasound blood flow parameters of UA and MCA and fetal distress were analyzed.Results The RI,PI and S/D of UA and MCA in the umbilical cord around neck group were higher than those in the non-umbilical cord around neck group(P<0.05).The RI,PI and S/D of UA and MCA in the 28-36 weeks group were lower than those in the≥37 weeks group(P<0.05).The PI and S/D of UA in the intrauterine distress group were higher than those in the non-intrauterine distress group,and the RI,PI and S/D of MCA in the intrauterine distress group were higher than those in the non-intrauterine distress group(P<0.05).The Logistic regression analysis showed that PI,RI and S/D of UA and MCA were significantly correlated with fetal distress(P<0.05).Conclusion The ultrasound blood flow parameters(PI,RI and S/D)of UA and MCA in fetuses with umbilical cord around neck were higher than those in fetuses without umbilical cord around neck,especially in late pregnancy;RI,PI and S/D of UA and MCA were highly correlated with fetal distress.