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目的探讨妊高征孕妇脐血流的参数改变与围产儿结局的相关性。方法检测86例妊高征孕妇的脐带在胎盘插入点处脐血流参数S/D值,搏动指数(PI),阻力指数(RI),随访孕妇生产方式、新生儿出生体重、Apgar评分等。结果①妊高征组中PI、RI及S/D值(除外轻度妊高征组)均高于正常对照组(P<0.01),与正常对照组比较差异均有统计学意义;②有先兆子痫及子痫症状的中重度妊高征组中剖宫产率、新生儿窒息、宫内窘迫及低体重出生儿的发生率明显高于正常组(P<0.01),差异具统计学意义,而轻度妊高征组中以上指标与正常组比较差异无统计学意义(P>0.05)。结论对妊高征孕妇脐血流S/D、PI、RI值的监测可作为评估胎儿宫内生存状况的敏感指标,尤其将脐血流在胎盘脐带插入点处测定获取的是母体妊高征血流对胎儿影响的直接反映,可指导分娩方式提高围产儿的生存质量。
Objective To investigate the correlation between umbilical cord blood flow parameters and perinatal outcome in pregnant women with PIH. Methods The umbilical cord blood flow parameters S / D, PI, RI of 86 cases of pregnant women with PIH were detected at the placenta insertion site. The follow-up pregnant women ’s birth patterns, birth weight, Apgar score and so on were detected. Results ① The PI, RI and S / D values (except mild PIH) in PIH group were significantly higher than those in control group (P <0.01), and there were significant differences between PIH group and control group The incidence of cesarean section, neonatal asphyxia, intrauterine distress and low birth weight infants in the group of moderate and severe PIH with preeclampsia and eclampsia was significantly higher than that of the normal group (P <0.01), the difference was statistically significant However, there was no significant difference between the above indexes in mild PIH group and normal group (P> 0.05). Conclusion The monitoring of S / D, PI, RI values of umbilical blood flow in pregnant women with PIH can be used as a sensitive index to evaluate the fetal survival status. In particular, umbilical cord blood flow at maternal umbilical cord insertion point is obtained from maternal pregnancy-induced hypertension The direct effect of blood flow on the fetus can guide the mode of delivery to improve the quality of life of perinatal children.