Department of Obstetrics and Gynecology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Paldal-gu, Suwon, Kyeonggi, 442-723, Korea.
Arch Gynecol Obstet. 2011 Jul;284(1):73-8. doi: 10.1007/s00404-010-1597-8. Epub 2010 Jul 24.
The aim of this study was to evaluate the effect of absent or reversed end-diastolic umbilical artery Doppler flow on neonatal outcome independent of oligohydramnios, gestational age, and maternal factors.
From January 2004 to March 2010 we reviewed 76 cases at our hospital, which were diagnosed with intrauterine growth restriction (IUGR). Among those cases, the existence of absent or reversed end-diastolic velocity of umbilical artery (AEDV) was considered abnormal. We set the group that had no abnormal signs as the control group (57 cases), and compared it with the AEDV group (19 cases). Logistic regression was used to control for oligohydramnios and gestational age.
The gestational age was lower in the AEDV group compared to that of the control group. Neonatal weight, platelet count were also lower in the AEDV group and serum SGOT level, the frequency of non-reassuring fetal heart beat pattern were higher in AEDV group compared to that of the control group independent of gestational age. Perinatal outcomes such as Apgar score at 1 min below 4, use of a ventilator, admission to the neonatal intensive care unit (NICU), respiratory disease, neurologic disease, neonatal sepsis, anemia, thrombocytopenia, and neonatal mortality were statistically less favorable in the AEDV group compared to those in the control group independent of gestational age and presence of oligohydramnios. There were more intrauterine fetal death histories and preeclampsia in the AEDV group compared the control group.
The waveform of umbilical artery Doppler velocity is an informative parameter of perinatal outcomes independent of gestational age or the presence of oligohydramnios in IUGR patients. It is especially important to check the waveform of umbilical artery Doppler velocity in IUGR patients with preeclampsia and IUGR patients with FDIU history.
本研究旨在评估脐动脉多普勒血流舒张末期缺失或逆转对新生儿结局的影响，而不考虑羊水过少、孕龄和母体因素。
2004 年 1 月至 2010 年 3 月，我们回顾了我院 76 例宫内生长受限（IUGR）患者的病例，其中存在脐动脉舒张末期缺失或逆转（AEDV）被认为是异常的。我们将无异常征象的组设为对照组（57 例），并与 AEDV 组（19 例）进行比较。采用 Logistic 回归控制羊水过少和孕龄。
AEDV 组的孕龄明显低于对照组。AEDV 组新生儿体重、血小板计数也低于对照组，而血清 SGOT 水平、非反应性胎心监护模式的发生率高于对照组，与孕龄无关。与对照组相比，AEDV 组新生儿 1 分钟 Apgar 评分<4、使用呼吸机、入住新生儿重症监护病房（NICU）、呼吸疾病、神经疾病、新生儿败血症、贫血、血小板减少症和新生儿死亡率等围产期结局在统计学上较差，与孕龄和羊水过少无关。AEDV 组宫内胎儿死亡史和子痫前期的发生率高于对照组。
在 IUGR 患者中，脐动脉多普勒血流速度的波形是预测围产期结局的一个重要指标，与孕龄或羊水过少无关。在有子痫前期和胎儿生长受限史的胎儿生长受限患者中，检查脐动脉多普勒血流速度的波形尤其重要。
