Khanduri Sachin, Chhabra Saakshi, Yadav Santosh, Sabharwal Tushar, Chaudhary Mriganki, Usmani Tarim, Goyal Aakshit, Sharma Hritik
Radiodiagnosis, Era's Lucknow Medical College and Hospital.
Cureus. 2017 Nov 8;9(11):e1827. doi: 10.7759/cureus.1827.
To evaluate the usefulness of Color Doppler flowmetry in the prediction of intrauterine growth restriction (IUGR) in high-risk pregnancies.
A total of 62 high-risk pregnant women underwent Color Doppler flowmetric umbilical artery pulsatility index (PI), resistive index (RI) and systolic/diastolic (S/D) ratio, middle cerebral artery PI, RI and S/D ratio, Ductus venosus S-wave/isovolumetric A-wave index (SIA) and vertebral artery RI at 23-27 weeks, 28-32 weeks and 32-36 weeks of their pregnancy. Cerebral-umbilical C/U PI, RI and S/D were evaluated at the third visit. All the pregnancies were followed up till delivery. Ponderal index <10 was considered to be indicative of IUGR. Data were analyzed using IBM Statistical Package for Social Sciences (SPSS) 21.0.
Thirty-nine (62.9%) deliveries were IUGR. On all the three visits, umbilical artery, mean PI, RI and SD values were significantly higher while MCA PI, RI and SD values were significantly lower in IUGR as compared to non-IUGR cases. Third visit C/U PI, RI and SD ratio values were also significantly lower in IUGR as compared to non-IUGR cases. Ductus venosus SIA values did not show a significant difference between IUGR and non-IUGR groups. The vertebral artery resistive index was significantly higher in non-IUGR as compared to IUGR on all the visits. Umbilical artery PI was the most sensitive and specific for the prediction of IUGR at all the three visits, with the maximum sensitivity and specificity at the third visit (82.1% and 87%). Third visit C/U PI was most sensitive (82.1%) and specific (96.7%) for the prediction of IUGR.
This showed that Doppler flowmetry is a useful method for the prediction of IUGR in high-risk pregnancies.
评估彩色多普勒血流测定法在预测高危妊娠中胎儿宫内生长受限(IUGR)方面的效用。
共有62例高危孕妇在妊娠23 - 27周、28 - 32周和32 - 36周时接受了彩色多普勒血流测定,测量脐动脉搏动指数(PI)、阻力指数(RI)和收缩/舒张(S/D)比值、大脑中动脉PI、RI和S/D比值、静脉导管S波/等容A波指数(SIA)以及椎动脉RI。在第三次检查时评估脑 - 脐C/U PI、RI和S/D。所有妊娠均随访至分娩。体重指数<10被认为提示IUGR。使用IBM社会科学统计软件包(SPSS)21.0对数据进行分析。
39例(62.9%)分娩为IUGR。在所有三次检查中,与非IUGR病例相比,IUGR病例的脐动脉平均PI、RI和SD值显著更高,而大脑中动脉PI、RI和SD值显著更低。与非IUGR病例相比,IUGR病例第三次检查时的C/U PI、RI和SD比值也显著更低。静脉导管SIA值在IUGR组和非IUGR组之间未显示出显著差异。在所有检查中,非IUGR病例的椎动脉阻力指数均显著高于IUGR病例。脐动脉PI在所有三次检查中对IUGR的预测最为敏感和特异,在第三次检查时敏感性和特异性最高(分别为82.1%和87%)。第三次检查时的C/U PI对IUGR的预测最敏感(82.1%)且特异(96.7%)。
这表明多普勒血流测定法是预测高危妊娠中IUGR的一种有用方法。