Chen Ji, Liu Fei-Xue, Tao Rui-Xue
Department of Obstetrics, The Third Affiliated Hospital of Anhui Medical University, Hefei 230061, Anhui Province, China.
Anhui Medical University, First Clinical School of Medium,Class 2021,Clinical Medicine, Hefei 230032, Anhui Province, China.
World J Clin Cases. 2024 Jun 6;12(16):2745-2750. doi: 10.12998/wjcc.v12.i16.2745.
By comprehensively analyzing the blood flow parameters of the umbilical and middle cerebral arteries, doctors can more accurately identify fetal intrauterine distress, as well as assess its severity, so that timely interventions can be implemented to safeguard the health and safety of the fetus.
To identify the relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine distress.
Clinical data of pregnant women admitted between January 2021 and January 2023 were collected and divided into the observation and control groups ( = 50 each), according to the presence or absence of intrauterine distress. The ultrasound hemodynamic parameters of the uterine artery (UtA), fetal middle cerebral artery (MCA), and umbilical artery (UmA) were compared with neonatal outcomes and occurrence of intrauterine distress in the two groups.
Comparison of ultrasonic hemodynamic parameters, resistance index (RI), pulsatility index (PI), and systolic maximal blood flow velocity of UmA compared to diastolic blood flow velocity (S/D), revealed higher values of fetal MCA, PI, and S/D of UmA in pregnant women with UtA compared to controls ( < 0.05), while there was no difference between the two groups in terms of RI ( < 0.05) The incidence of a neonatal Apgar score of 8-10 points was lower in the observation group (66.7%) than in the control group (90.0%), and neonatal weight (2675.5 ± 27.6 g) was lower than in the control group (3117.5 ± 31.2 g). Further, cesarean section rate was higher in the observation group (70.0%) than in the control group (11.7%), and preterm labor rate was higher in the observation group (40.0%) than in the control group (10.0%). The incidence of fetal distress, neonatal growth restriction and neonatal asphyxia were also higher in the observation group (all < 0.05).
Fetal MCA, UmA, and maternal UtA hemodynamic abnormalities all develop in pregnant women with intrauterine distress during late pregnancy, which suggests that clinical attention should be paid to them, and monitoring should be strengthened to provide guidance for clinical intervention.
通过综合分析脐动脉和大脑中动脉的血流参数，医生能够更准确地识别胎儿宫内窘迫，并评估其严重程度，从而及时采取干预措施，保障胎儿的健康与安全。
确定脐动脉和大脑中动脉的超声参数与宫内窘迫之间的关系。
收集2021年1月至2023年1月期间入院的孕妇临床资料，根据是否存在宫内窘迫分为观察组和对照组（每组各50例）。比较两组子宫动脉（UtA）、胎儿大脑中动脉（MCA）和脐动脉（UmA）的超声血流动力学参数与新生儿结局及宫内窘迫的发生情况。
超声血流动力学参数比较，脐动脉阻力指数（RI）、搏动指数（PI）及收缩期最大血流速度与舒张期血流速度比值（S/D）显示，观察组孕妇胎儿MCA、PI及UmA的S/D值高于对照组（P<0.05），而两组间RI无差异（P>0.05）。观察组新生儿Apgar评分8 - 10分的发生率（66.7%）低于对照组（90.0%），新生儿体重（2675.5±27.6g）低于对照组（3117.5±31.2g）。此外，观察组剖宫产率（70.0%）高于对照组（11.7%），早产率（40.0%）高于对照组（10.0%）。观察组胎儿窘迫、新生儿生长受限及新生儿窒息的发生率也更高（均P<0.05）。
妊娠晚期发生宫内窘迫的孕妇，胎儿MCA、UmA及母体UtA均出现血流动力学异常，提示临床应予以关注并加强监测，为临床干预提供指导。
