妊娠期肝内胆汁淤积症围产儿的血流检测与预后

目的评价彩色多普勒超声在预测妊娠期肝内胆汁淤积症(ICP)围产儿预后中的价值。方法检测46例ICP组及50例正常对照组胎儿脐动脉(UA)、大脑中动脉(MCA)及肾动脉(RA)血流阻力指标(S/D、PI、RI),计算PIMCA/PIUA值,并与妊娠结局对照。结果 37例单纯ICP胎儿UA、MCA、RA的S/D、PI、RI高于正常组;9例ICP并发胎儿宫内窘迫者,UA、RA的S/D、PI、RI明显高于正常组,而MCA的S/D、PI、RI明显低于正常组(P<0.01),预后不良。结论检测ICP胎儿多指标血流参数,以PIMCA/PIUA<2作为围产儿预后不良的预测指标,对预测胎儿宫内缺氧及不良结局有重要参考意义。

Study on the hemodynamics parameters in detection and prognosis of perinatal embryo with intrahepatic cholestasis of pregnancy

Objective The study was to evaluate the value of colored Doppler in predicting the prognosis of perinatal embryo with intrahepatic cholestasis of pregnancy（ICP）.Methods Hemodynamics parameters（S/D,PI,RI） of fetal umbilical artery（UA）,middle cerebral artery（MCA） and renal artery（RA） were detected in 46 cases with ICP and 50 cases normal control group and the value of PIMCA/PIUA with the pregnancy result.Results S/D,PI,RI of UA,MCA,RA in the group of 37 cases with ICP were higher than those in normal group.In 9 ICP cases associated with fetal distress,S/D,PI,RI of UA,RA were obviously higher than those in normal group.But S/D,PI,RI of MCA were distinctly lower than the normal group（P0.01）,with poor prognosis.Conclusion To detect the multi-index hemodynamics parameters of ICP embryo,and to take PIMCA/PIUA2 as the predicting index of perinatal embryo with poor prognosis,the accordance rate was 89.2%.This has important reference significance for predicting the intrauterine fetal anoxia and bad results.