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应用脐动脉和大脑中动脉彩色多普勒评估胎儿宫内生长受限妊娠的围产期结局

Perinatal outcome in pregnancies with intra-uterine growth restriction by using umbilical and middle cerebral artery colour Doppler.

作者信息

Roy Anita, Mukherjee Swarup, Bhattacharyya Subir Kumar, Banerjee Prasenjit, Das Bibekananda, Patra Kajal Kumar

机构信息

Department of Obstetrics and Gynaecology, RG Kar Medical College and Hospital, Kolkata 700004.

出版信息

J Indian Med Assoc. 2012 Mar;110(3):154-7, 163.

Abstract

There are various biophysical methods used for diagnosing and monitoring foetal well being using in intra-uterine growth restriction foetus, out of which Doppler velocimetry proved to possess the predictive capacity in diagnosing and management of intra-uterine growth restriction foetuses. The objectives were to study Doppler velocimetry of foetal umbilical artery and middle cerebral artery in diagnosing intra-uterine growth restriction and to correlate Doppler finding with perinatal outcome. Random 50 patients with singleton pregnancies admitted in RG Kar Medical College and Hospital were studied in a duration of 1 year. Umbilical artery and middle cerebral artery were studied during foetal inactivity and apnoea. Percentage of normal and abnormal Doppler velocimetry of umbilical artery and middle cerebral artery was observed and its relation with perinatal outcome analysed. Out of 50 patients, 30% had normal and 70% had abnormal umbilical artery Doppler velocimetry. Neonatal intensive care unit admission was 20% in normal and 71.42% in abnormal umbilical artery Doppler, 46.4% in normal and 68.1% in abnormal middle cerebral artery Doppler and 9.09% in normal and 69.23% in abnormal cerebroplacental index. Neonatal mortality was 0% in normal and 14.3% in abnormal umbilical artery Doppler velocimetry. Oligohydramnios was 26% in normal and 71% in abnormal umbilical artery Doppler. The study revealed that overall perinatal outcome was poor in abnormal Doppler velocimetry group in comparison to normal group. Doppler investigation of the foetal circulation not only plays an important role in monitoring of the growth restricted foetuses but also helps in detecting foetal compromises early in intra-uterine growth restriction foetuses and thereby helps to determine the optimal time for delivery.

摘要

有多种生物物理方法用于诊断和监测宫内生长受限胎儿的胎儿健康状况,其中多普勒测速法在诊断和管理宫内生长受限胎儿方面具有预测能力。目的是研究胎儿脐动脉和大脑中动脉的多普勒测速法在诊断宫内生长受限中的应用,并将多普勒检查结果与围产期结局相关联。在1年的时间里,对随机入住RG Kar医学院和医院的50名单胎妊娠患者进行了研究。在胎儿静止和呼吸暂停期间研究脐动脉和大脑中动脉。观察脐动脉和大脑中动脉多普勒测速法正常和异常的百分比,并分析其与围产期结局的关系。50名患者中,30%的脐动脉多普勒测速法正常,70%异常。脐动脉多普勒正常组新生儿重症监护病房入院率为20%,异常组为71.42%;大脑中动脉多普勒正常组为46.4%,异常组为68.1%;脑胎盘指数正常组为9.09%,异常组为69.23%。脐动脉多普勒测速法正常组新生儿死亡率为0%,异常组为14.3%。羊水过少在脐动脉多普勒正常组中为26%,异常组中为71%。研究表明,与正常组相比,多普勒测速法异常组的总体围产期结局较差。对胎儿循环进行多普勒检查不仅在监测生长受限胎儿方面起着重要作用,而且有助于在宫内生长受限胎儿早期检测胎儿窘迫,从而有助于确定最佳分娩时间。

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