多普勒频谱分析胎儿宫内缺氧

目的综合分析子宫动脉、脐动脉及大脑中动脉多普勒指标(PI值)变化关系对评价胎儿缺氧的意义。方法运用多普勒技术检测90例因不良妊娠住院患者子宫动脉、胎儿脐动脉及大脑中动脉搏动指数(PI),回顾分析妊娠结局与各频谱参数变化的关系。结果子宫动脉异常(PI≥95th)伴脐动脉参数升高(PI>50th)和(或)大脑中动脉参数降低(PI<50th)者妊娠结局不良,且脐动脉参数升高至异常时(PI≥95th)围产儿病死率增高;子宫动脉正常时(PI<95th),脐动脉参数异常(PI≥95th)伴大脑中动脉参数降低者(PI<50th)妊娠结局不良;大脑中动脉血流参数异常者(PI≤5th)妊娠结局不良;单一子宫动脉或脐动脉血流参数异常者(PI≥95th)妊娠结局良好。结论综合分析子宫动脉、脐动脉及大脑中动脉频谱指标变化关系,可判定及评估胎儿缺氧情况、提示预后。

The Clinical Value of Doppler Ultrasound in Evaluating the Fetal Hypoxia

Objective To investigate the clinical application of Doppler flow parameters(UtA,UA and MCA Pulsatility Index)in evaluating the Fetal hypoxia.Methods 90 term inpatients judged of having adverse pregnancy were test using Doppler ultrasound,Doppler flow parameters include of uterine artery(UtA),umbilical artery(UA)and Middle cerebral artery(MCA)pulsatility index(PI)were recorded.In the end,the adverse pregnancy outcome was recorded and analyzed.Results Pregnancy outcomes were poor in patients with abnormal uterine artery(PI≥95th)accompanied by increased umbilical artery parameters(PI>50th)and/or decreased middle cerebral artery parameters(PI<50th),and perinatal mortality increased when the umbilical artery parameters increased to abnormal(PI≥95th);In normal uterine artery(PI<95th),abnormal umbilical artery parameters(PI≥95th)accompanied by decreased middle cerebral artery parameters(PI<50th)resulted in poor pregnancy outcomes;Pregnancy outcomes were poor in those with abnormal middle cerebral artery parameters(PI≤5th),and good in those with abnormal blood flow parameters of single uterine or umbilical artery(PI≥95th).Conclusions Comprehensive analysis of the trend of Doppler flow parameters of uterine artery,umbilical artery and middle cerebral artery can determine and evaluate fetal hypoxia and indicate prognosis.