彩色多普勒超声评价胎儿脐带缠绕程度及临床意义

目的：探讨彩色多普勒超声（CDFI）诊断妊娠晚期胎儿颈、胸部脐带缠绕程度不同时脐动脉S／D值及RI变化对预测胎儿宫内窘迫的价值。方法：将诊断为胎儿脐带缠绕107例患者分为脐带缠绕较紧组（11例）和脐带缠绕较松组（96例)。CDFI观察胎儿脐动脉S／D、RI，胎儿脐带缠绕处压迹的形态、胎儿心率及呼吸状况。并与20例正常妊娠晚期妇女对照观察。结果：11例胎儿颈部脐带缠绕较紧者，缠绕处压迹较深，S／D值＞3．0，较胎儿脐带缠绕松组及对照组明显增高，并伴有不同程度胎儿心率增快及呼吸急促，部分可见明显腹式呼吸；胎儿脐带缠绕较松组与对照组之间无明显差异。结论：CDFI检测对预测胎儿宫内窘迫，指导分娩方式的选择有重要参考意义，其中S／D值为较好的观察指标。

Study on Umbilical Cord Around Body with Color Doppler Ultrasonography

Objective: To study the respiratory distress of mature pregancy fetus with umbilical cord around body (UCAB) by color doppler ultrasonography according to the umbilical systolic/diastolic (S/D) ratios and resistance index (RI). Methods: Among the 192 cases of suspected UCAB, 107 cases were diagnosed by color doppler ultrasonography and were divided into tight and loose UCAB group,another 20 cases without UCAB were chosen as control group.The RI and S/D of the umbilical cord artery flow and the heart beating and the respiratory condition of the fetus were examined. Results: Compared with those of the loose and the control group, the RI and the S/D of the tight group were significantly increased and the fetus with tight UCAB took on short of breath and tachycardia. However, there was no obvious difference of RI and S/D between the loose and control group. Conclusions: Color doppler ultrasonography is an useful method in observing the umbilical artery blood flow; parameter of fetus with UCAB and the cases with tight UCAB can be the predictive indication of caesarean section.