Makhseed M, Jirous J, Ahmed M A, Viswanathan D L
Maternity Hospital, Safat, Kuwait.
Int J Gynaecol Obstet. 2000 Nov;71(2):119-25. doi: 10.1016/s0020-7292(00)00262-9.
The objectives of this study were to evaluate the usefulness of the middle cerebral artery to umbilical artery resistance index ratio (C/U ratio) as a predictor of adverse perinatal outcome, and to show that the absence of fetal umbilical artery end-diastolic velocity (AEDV) in SGA fetuses is associated with high morbidity and mortality.
In this prospective study, color Doppler flow imaging was used for the estimation of the C/U ratio in fetuses that were small for their gestational age, in 70 singleton pregnancies between 29 and 42 weeks of gestation. The subjects were categorized into two groups, with Group A consisting of 35 small for gestational age (SGA) fetuses with a normal C/U ratio (1.05 or higher), and Group B comprising 35 SGA fetuses with an abnormal C/U ratio (below 1.05).
The mean C/U ratio values for birth weight and gestational age were higher in group A than in group B. Fetuses born to mothers in group B stayed longer in the neonatal special care unit (NSCU), whereas the period from ultrasound examination to delivery was higher in the cases in group A. A higher percentage of mothers with an abnormal C/U ratio underwent cesarean section. Fetuses with an absent end-diastolic velocity of the umbilical artery had a higher morbidity. Three stillbirths occurred in fetuses with an absent end-diastolic velocity of the umbilical artery.
Our results suggest that the C/U ratio is a good predictor of neonatal outcome, and could be used to identify fetuses at risk of morbidity and mortality. Fetal umbilical artery AEDV with intrauterine growth restriction is associated with high perinatal morbidity and mortality.
本研究的目的是评估大脑中动脉与脐动脉阻力指数比值（C/U比值）作为围产期不良结局预测指标的有效性，并表明小于胎龄（SGA）胎儿脐动脉舒张末期血流速度（AEDV）缺失与高发病率和死亡率相关。
在这项前瞻性研究中，采用彩色多普勒血流成像技术对29至42周妊娠的70例单胎妊娠、小于胎龄胎儿的C/U比值进行评估。研究对象分为两组，A组由35例C/U比值正常（1.05或更高）的小于胎龄胎儿组成，B组由35例C/U比值异常（低于1.05）的小于胎龄胎儿组成。
A组出生体重和孕周的平均C/U比值高于B组。B组母亲所生胎儿在新生儿重症监护病房（NSCU）停留时间更长，而A组病例从超声检查到分娩的时间更长。C/U比值异常的母亲剖宫产率更高。脐动脉舒张末期血流速度缺失的胎儿发病率更高。脐动脉舒张末期血流速度缺失的胎儿中有3例死产。
我们的结果表明，C/U比值是新生儿结局的良好预测指标，可用于识别有发病和死亡风险的胎儿。宫内生长受限胎儿的脐动脉AEDV与高围产期发病率和死亡率相关。
