Hata T, Aoki S, Manabe A, Kanenishi K, Yamashiro C, Tanaka H, Yanagihara T
Department of Perinatology, Kagawa Medical University, Kagawa, Japan.
Gynecol Obstet Invest. 2000;49(4):236-9. doi: 10.1159/000010266.
Our purpose was to determine whether small-for-gestational-age (SGA) fetus can be divided to subclassified groups using fetal Doppler velocimetry. Fifty-four pregnant women with SGA infant delivered after 37 weeks of gestation were studied. After 24 weeks of gestation, fetal middle cerebral artery puslatility index (MCAPI) and umbilical artery pulsatility index (UAPI) were measured at 2- to 3-week intervals using Doppler ultrasound. Perinatal outcomes [operative delivery due to fetal distress, abnormal fetal heart rate (FHR) pattern, meconium staining, low Apgar score (<7), neonatal acidosis (umbilical artery blood pH <7.15), neonatal intensive care unit (NICU) admission due to neonatal asphyxia, and decreased amniotic fluid] were compared in subclassified SGA groups using fetal Doppler velocimetry. The number of SGA fetuses with normal MCAPI and UAPI (normal SGA group) was 39, and those with significantly low MCAPI but normal UAPI (eventful SGA group) 15, respectively. Birth age and birth weights in the eventful SGA group were significantly earlier and lower than those in the normal SGA group, respectively (p < 0.05, and p < 0.005). There were significant increases in operative deliveries, abnormal FHR patterns and decreased amniotic fluid in eventful SGA group, when compared with events related to normal SGA group. However, there were no significant differences in meconium staining of amniotic fluid, low Apgar score, neonatal acidosis, and NICU admission between the two groups. These results suggest that SGA fetus with abnormally low MCAPI but normal UAPI has more poor perinatal outcomes, compared with that with normal MCAPI and UAPI.
我们的目的是确定是否可以使用胎儿多普勒测速法将小于胎龄（SGA）胎儿分为亚分类组。研究了54例妊娠37周后分娩出SGA婴儿的孕妇。妊娠24周后，使用多普勒超声每隔2至3周测量胎儿大脑中动脉搏动指数（MCAPI）和脐动脉搏动指数（UAPI）。比较了使用胎儿多普勒测速法在亚分类SGA组中的围产期结局[因胎儿窘迫、异常胎儿心率（FHR）模式、羊水胎粪污染、低Apgar评分（<7）、新生儿酸中毒（脐动脉血pH<7.15）、因新生儿窒息入住新生儿重症监护病房（NICU）以及羊水减少而进行的手术分娩]。MCAPI和UAPI正常的SGA胎儿（正常SGA组）有39例，MCAPI显著降低但UAPI正常的SGA胎儿（情况复杂的SGA组）有15例。情况复杂的SGA组的出生孕周和出生体重分别显著早于和低于正常SGA组（p<0.05和p<0.005）。与正常SGA组相关事件相比，情况复杂的SGA组的手术分娩、异常FHR模式和羊水减少显著增加。然而，两组之间羊水胎粪污染、低Apgar评分、新生儿酸中毒和NICU入住率没有显著差异。这些结果表明，与MCAPI和UAPI正常的SGA胎儿相比，MCAPI异常低但UAPI正常的SGA胎儿围产期结局更差。
