目的:探讨妊娠期胎儿脐动脉和大脑中动脉阻力指标比值预测胎儿宫内窘迫的价值。方法:应用彩色多普勒超声检测100例正常妊娠和46例胎儿宫内窘迫胎儿脐动脉(UA)、大脑中动脉(MCA)阻力指数(RI)、搏动指数(PI)及S/D值,计算UA与MCA各指标比值。结果:胎儿宫内窘迫组胎儿UA阻力指标均明显高于正常对照组(P〈0.01),MCA阻力指标均低于正常对照组(P〈0.05),UA和MCA阻力指标比值高于正常组(P〈0.01)。以(RIUA/MCA)〉1.00,(PIUA/MCA)〉1.00,(SUA/DUA)/(SMCA/DMCA)〉0.60提示胎儿宫内窘迫的敏感性、特异性分别为89%、96%。结论:胎儿脐动脉和大脑中动脉指标比值预测胎儿宫内缺氧具有较高的敏感性和特异性。
Objective:To study the diagnostic value of the resistance parameter rations of fetal umbilical artery (UA) to middle cerebral artery (MCA) in predicting fetal distress in pregnancy. Methods:Color Doppler was used to examine fetal UA and MCA blood flow waveforms in two groups: normal pregnancy (100 eases) and pregnancy with fetal distress (46 cases). The resistant index (RI), Palsatility index (PI), and peak systolic to end diastolic ratio (S/D) were evaluated and the resistant parameter ratios of UA to MCA were calculated and analysed.Results:The RI, PI and S/D of fetal UA in the patient group were significandy higher than those in the normal group ( P 〈 0.01) and RI, PI and S/D of fetal MCA were lower than those of normal group ( P 〈 0.05). The RIUA/MCA,PIUA/MCA and (SUA/DUA)/(SMCA/DMCA) of the patient group were higher than those of the normal group ( P 〈 0.01 ). Using RIUA/MCA〉 1.00, PIUA/MCA 〉 1.00 and (SUA/DUA)/(SMCA/DMCA) 〉 0.60 as the cutoff, the sensitivity and specificity in predicting fetal distress were 89% and 96% .Conclusion:The resistant parameter ratios of fetal UA and MCA have higher sensitivity and specificity in predicting fetal distress.