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目的观察胎儿脐动脉收缩期最大血流速度(S)与舒张末期血流速度(D)的比值(S/D)、阻力指数(RI),探讨其与胎儿宫内窘迫的相关性,分析其预测围产儿预后的实用价值。方法应用彩色多普勒血流显像(CDFI)对我院妇产科住院的764例孕37～42周单胎初产妇进行超声产科常规检查,并对胎儿颈部进行观察,同时测定脐动脉S/D值、RI值,做详细记录,最后结合分娩方式、产后羊水粪染、产后1分钟Apgar评分进行分析。结果(1)CDFI诊断脐带绕颈具有较高的筛查价值,检出率高,漏诊率低,其诊断价值显著优于二维超声。(2)脐带绕颈组与无脐带绕颈组脐动脉S/D值、RI值相比,有显著性差异(P<0.005)。(3)脐带绕颈组脐动脉S/D值≥2.9、RI值≥0.6组与其他组比较,胎儿宫内窘迫发生率有显著性差异(P<0.001),其胎心监测阳性率、羊水粪染率及新生儿窒息发生率显著增高(P<0.001)。结论CDFI检测脐动脉S/D值、RI值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。
Objective To observe the relationship between fetal umbilical artery systolic maximum blood flow (S) and end-diastolic blood flow (D) (S / D) and resistance index (RI) and to investigate its correlation with fetal distress Predict the utility value of perinatal prognosis. Methods A total of 764 cases of singleton primiparous women aged 37-42 weeks hospitalized in obstetrics and gynecology department of our hospital underwent routine ultrasound examination by color Doppler flow imaging (CDFI). The fetal neck was observed and the umbilical artery S / D value, RI value, make a detailed record, and finally combined with mode of delivery, postpartum amniotic meconium staining, Apgar score postpartum 1 minute analysis. Results (1) CDFI diagnosis of umbilical cord around the neck has a higher screening value, the detection rate is high, the rate of missed diagnosis, the diagnostic value significantly better than two-dimensional ultrasound. (2) There was a significant difference (P <0.005) between S / D value and RI value of umbilical cord around neck group and umbilical cord around neck group. (3) Umbilical cord around the neck group umbilical artery S / D value ≥ 2.9, RI value ≥ 0.6 group compared with other groups, the incidence of fetal distress was significantly different (P <0.001), the positive rate of fetal heart rate monitoring, amniotic fluid Meconium rates and neonatal asphyxia were significantly higher (P <0.001). Conclusion CDFI detection of umbilical artery S / D value, RI value for the prediction of fetal distress, guide the choice of mode of delivery has important reference value.