中国实用妇科与产科杂志

中国实用妇科与产科杂志

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静脉导管血流频谱预测妊娠期高血压疾病胎儿结局的价值

孙懿，关云萍，项宇识   

  1. 作者单位：沈阳市妇婴医院超声科，辽宁 沈阳 110011
  • 出版日期:2014-07-02 发布日期:2014-07-07

Monitoring fetal ductus venosus flow spectrum in predicting the prognosis of fetuses in women with hypertensive disorder complicating pregnancy.

SUN Yi, GUAN Yun-ping, XIANG Yu-shi.   

  1. Department of Ultrasound, Shenyang Women’s and Children’s Hospital, Shenyang 110011, China
  • Online:2014-07-02 Published:2014-07-07

摘要：

目的 探讨静脉导管（DV）血流频谱各参数在预测妊娠期高血压疾病(HDCP)胎儿结局中的应用价值。方法 应用彩色多普勒超声检查2012年1月至2013年10月在沈阳市妇婴医院就诊的60例正常单胎胎儿及38例HDCP单胎胎儿，测量DV血流频谱速度参数值及阻力参数值。 结果 轻度子痫前期组各阻力参数较正常组明显升高（P<0.05），速度参数无明显变化（P＞0.05）；重度子痫前期组各速度参数较正常组及轻度组明显下降（P<0.05），Va尤为显著，2例出现“a”谷反转，均胎死宫内，各阻力参数较正常组及轻度组明显升高（P<0.05），其中Vs/Va对于提示重度子痫前期胎儿生长受限的敏感度为80.0%，特异度为66.7%。结论 轻度子痫前期胎儿DV血流频谱速度参数与正常胎儿相比无明显差异，重度子痫前期胎儿速度参数较正常、轻度子痫前期胎儿明显下降；阻力参数在正常、轻度子痫前期、重度子痫前期胎儿中呈递增趋势；Vs/Va对于预测重度子痫前期胎儿生长受限有一定的价值，“a”谷反转对于预测胎儿不良结局有一定意义。

关键词: 妊娠期高血压疾病, 胎儿, 静脉导管, 血流频谱

Abstract:

Abstract： Objective To assess parameters of ductus venosus (DV) flow spectrum in the prediction of the prognosis of fetuses in women with hypertensive disorder complicating pregnancy. Methods A total of 60 cases of normal single fetus and 38 cases of single fetus in women with hypertensive disorder complicating pregnancy were examined by color Doppler ultrasound between January 2012 and October 2013 in Shenyang Women’s and Children’s Hospital. The blood flow velocity parameters and resistance parameters of DV were measured. Results The resistance parameters in mild preeclampsia group were higher significantly than those in normal group（P<0.05）. There was no significant difference in velocity parameters（P＞0.05）. The velocity parameters in severe preeclampsia group were lower than those in normal group and mild preeclampsia group（P<0.05）, especially Va. Two cases with “a” vale reversed dead in uterus. All resistance parameters were higher than those in normal group and mild preeclampsia group significantly（P<0.05）. The value of Vs/Va had high sensitivity (80.0%) and specificity (66.7%) in identifying fetal intrauterine growth restriction in women with severe preeclampsia. Conclusion There is no significant difference in velocity parameters between mild preeclampsia group and normal group. The velocity parameters in severe preeclampsia group are lower than those in normal group and mild preeclampsia group. The resistance parameters are in the increasing order of normal group, mild preeclampsia group and severe preeclampsia group. The value of Vs/Va can play a certain role in predicting fetal intrauterine growth restriction in women with severe preeclampsia. The reversal of “a” vale has certain significance in identifying poor outcome of fetus.

Key words: hypertensive disorder complicating pregnancy, fetus, ductus venosus, flow spectrum

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