Newnham J P, Patterson L L, James I R, Diepeveen D A, Reid S E
Ultrasound Department, King Edward Memorial Hospital for Women, Perth, Western Australia.
Am J Obstet Gynecol. 1990 Feb;162(2):403-10. doi: 10.1016/0002-9378(90)90396-o.
In a prospective double-blind study of 535 medium-risk pregnancies, growth data obtained by ultrasonography and Doppler flow velocity waveform systolic to diastolic ratios were recorded at 18, 24, 28, and 34 weeks' gestation. A significant association was observed between uteroplacental systolic to diastolic ratios at 24 weeks' gestation and subsequent fetal hypoxia with a sensitivity of 24.0% and a specificity of 93.9%. However, 70% of abnormal results were not followed by fetal hypoxia. Umbilical artery systolic to diastolic ratios at 24, 28, and 34 weeks' gestation were found to be predictive of intrauterine growth retardation. This predictive capability was enhanced in those growth-retarded fetuses in which hypoxia developed, but was weak when umbilical artery systolic to diastolic ratios were evaluated as primary screening tests for fetal hypoxia. The results confirm a role for Doppler systolic to diastolic ratios in the evaluation of high-risk pregnancies but do not support a role for their use as primary screening tests in low-risk obstetric populations.
在一项针对535例中度风险妊娠的前瞻性双盲研究中，于妊娠18、24、28和34周时记录通过超声检查获得的生长数据以及多普勒血流速度波形收缩期与舒张期比值。观察到妊娠24周时子宫胎盘收缩期与舒张期比值与随后的胎儿缺氧之间存在显著关联，敏感性为24.0%，特异性为93.9%。然而，70%的异常结果之后并未出现胎儿缺氧情况。发现妊娠24、28和34周时脐动脉收缩期与舒张期比值可预测宫内生长受限。这种预测能力在发生缺氧的生长受限胎儿中有所增强，但当将脐动脉收缩期与舒张期比值作为胎儿缺氧的初步筛查测试进行评估时，其预测能力较弱。结果证实了多普勒收缩期与舒张期比值在评估高危妊娠中的作用，但不支持将其用作低风险产科人群的初步筛查测试。
