摘要
目的:探讨早发型重度子痫前期患者胎儿脐动脉及大脑中动脉的血流动力学变化,判定围产儿生存及预后状况,评价彩色多普勒血流显像技术在早发型重度子痫前期的使用价值。方法:应用彩色多普勒检测100例正常晚期妊娠妇女和80例早发型重度子痫前期患者的胎儿脐动脉(UA)及大脑中动脉(MCA)的收缩末期最大血流速度和舒张末期最大血流速度之比(S/D)、搏动指数(PI)、阻力指数(RI),同时观察胎儿宫内发育情况(双顶径、股骨长度、胎儿体重),并记录新生儿出生体重、1min阿氏评分及胎儿窘迫、FGR、低体重儿的发生率。结果:早发型重度子痫前期组胎儿UA的S/D、PI、RI值均高于对照组,差异有统计学意义(P<0.05)。将早发型重度子痫前期患者分为UAS/D≥3和S/D<3两组比较其妊娠结局,前者1min阿氏评分<7分、胎儿窘迫、FGR、低体重儿的发生率均高于后者,差异有统计学意义(P<0.05)。将早发型重度子痫前期患者分为MCAS/D<4和S/D≥4两组比较其妊娠结局,前者1min阿氏评分<7分、胎儿窘迫发生率均高于后者,差异有统计学意义(P<0.05)。结论:早发型重度子痫前期患者存在胎盘-胎儿循环障碍,脐动脉及大脑中动脉阻抗增高、血供不足,这些病理生理变化与不良妊娠结局相关。彩色超声多普勒可以检测早发型重度子痫前期患者胎儿脐动脉及大脑中动脉血流动力学变化,在预测早发型重度子痫前期病情发展趋势和预测围产儿结局方面有重要的临床价值。
Objective： To explore the hemodynamic changes of fetal umbilical artery （UA） and middle cerebral artery （MCA） in patient with early onset severe preeclampsia, predict the fetal outcomes and prognosis, and evaluate the application value of color Doppler flowing imaging in early onset severe preeclampsia. Methods： The peak systolic velocity/peak diastolic velocity （S/D） ratio, pulsatility index （PI） and resistance index （RI） of UA and MCA in 100 normal late pregnant women and 80 pregnant women with early onset severe preeclampsia were detected by color Doppler ultrasound, the intrauterine growth status of fetus （ biparietal diameter, femur length, fetal body weight） were observed, and neonatal body weight, 1 minute Apgar score and the incidences of fetal distress, fetal growth retardation （ FGR）, infants of low - birth weight were recorded. Results： The S/D ratio, PI and RI of UA in early onset severe preeelampsia group were significantly higher than those in control group （P 〈 0. 05 ） . Patients in early onset severe preeclampsia group were divided into UA S/D ≥3 group and UA S/D 〈 3 group, the incidences of 1 minute Apgar score 〈 7, fetal distress, FGR and infants of low - birth weight in UA S/D≥ 3 group were significantly higher than those in UA S/D 〈 3 group （P 〈 O. 05 ） . Patients in early onset severe preeclampsia group were divided into MCA S/D 〈4 group and MCA S/D≥4 group, the incidences of 1 minute Apgar score 〈7 and fetal distress in MCA S/D 〈4 group were significantly higher than those in MCA S/D≥4 group （ P 〈 0. 05 ） . Conclusion： Disturbance of placenta - fetal circulation is found in patients with early onset severe preeclampsia, high impedance and insufficient blood supply of UA and MCA are related to adverse pregnancy outcomes. Color Doppler ultrasound can detect the hemodynamic changes of UA and MCA in patient with early onset severe preeelampsia, and plays an important role in predicting developmental trend of early onset severe preeclampsia and prognosis of perinatal infants.
出处
《中国妇幼保健》
CAS
北大核心
2010年第1期112-114,共3页
Maternal and Child Health Care of China
关键词
早发型重度子痫前期
脐动脉
大脑中动脉
彩色超声多普勒
Early onset severe preeclampsia
Umbilical artery
Middle cerebral artery
Color Doppler ultrasound
