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脐动脉不同点的多普勒指数差异能否预测脐带长度?

Can the difference of Doppler indexes at the different points of the umbilical artery predict to the umbilical cord length?

作者信息

Gur Esra Bahar, Gulec Ebru Sahin, Aydogmus Serpil, Gur Mehmet Serkan, Yazici Tekeli Elif, Kazimoglu Uğur

机构信息

Department of Obstetrics and Gynecology, Izmir Katip Celebi University School of Medicine, Izmir, Turkey.

Department of Obstetrics and Gynecology, Saglik Bilimleri University School of Medicine, Izmir, Turkey.

出版信息

J Matern Fetal Neonatal Med. 2020 Mar;33(5):847-851. doi: 10.1080/14767058.2018.1506440. Epub 2018 Sep 3.

Abstract

The aim of the study is to investigate whether the Doppler indexes which measured at different points of the umbilical cord (UC) are related to the cord length. In this prospective study, umbilical artery (UA) Doppler indexes were measured at the fetal and placental insertion, free loop (FL) and intra-abdominal (IA) portion at 37-42 weeks of gestation in low-risk singleton pregnancies. After birth, the UC was measured. The difference of Doppler indexes of different points was evaluated by nonparametric Kruskal-Wallis test or analysis of variance (ANOVA) test and significant values have been adjusted by the Bonferroni correction for multiply tests. The correlation of between UC length and change of Doppler indexes which measured at different points of the UC was evaluated using Spearman's rank correlation test. The data of 74 participants were analyzed in this study. Mean UC length was 58 cm (min: 38 cm and max: 84 cm). There was no difference between characteristics of two groups that UC length <58 cm and ≥58 cm and different percentiles. UA systole/diastole (S/D) rate, resistance index (RI), and pulsatility index (PI) were higher at the IA portion than other measurement points ( = .003, <.001, and <.001, respectively). The mean differences (delta values) of UA blood velocity between the fetal and placental ends (PEs) were correlated UC length ( = 0.32,  = .04). The differences of UA blood velocities between the fetal and PEs may be a useful marker for UC length prediction during antenatal period.

摘要

本研究的目的是调查在脐带(UC)不同点测量的多普勒指数是否与脐带长度相关。在这项前瞻性研究中,对低风险单胎妊娠孕37 - 42周时胎儿和胎盘附着处、游离环(FL)及腹腔内(IA)部分的脐动脉(UA)多普勒指数进行了测量。出生后,测量脐带长度。不同点的多普勒指数差异通过非参数Kruskal - Wallis检验或方差分析(ANOVA)检验进行评估,显著值已通过Bonferroni校正进行多次检验调整。使用Spearman秩相关检验评估脐带长度与在脐带不同点测量的多普勒指数变化之间的相关性。本研究分析了74名参与者的数据。脐带平均长度为58厘米(最小值:38厘米,最大值:84厘米)。脐带长度<58厘米和≥58厘米的两组以及不同百分位数之间的特征无差异。IA部分的UA收缩期/舒张期(S/D)率、阻力指数(RI)和搏动指数(PI)高于其他测量点(分别为=0.003、<0.001和<0.001)。胎儿端与胎盘端(PEs)之间UA血流速度的平均差异(差值)与脐带长度相关(=0.32,=0.04)。胎儿端与PEs之间UA血流速度的差异可能是产前预测脐带长度的一个有用指标。

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