Bruner J B, Levy D W, Arger P H
Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia.
South Med J. 1993 Apr;86(4):418-22. doi: 10.1097/00007611-199304000-00009.
Ninety-two gravid women had Doppler insonation of the umbilical cord after diagnosis of various pregnancy complications. Calculations of the systolic-diastolic (S/D) ratio were plotted against a nomogram of values developed at the Hospital of the University of Pennsylvania. An S/D ratio greater than the 95th percentile for gestational age correctly predicted 58% of women who became preeclamptic and 61% of infants who were small for gestational age (SGA). Of those fetuses with an elevated S/D ratio, 42% suffered fetal distress as defined by an abnormal fetal heart rate tracing, a 1- or 5-minute Apgar score less than 5 or 7, respectively, or a cord blood pH determination less than 7.20; 60% required operative delivery; and 49% stayed in the hospital longer than 5 days or were admitted to the Neonatal Intensive Care Unit (NICU). All these values are significantly greater than those obtained in a control group of uncomplicated pregnancies or a group of women with similar pregnancies, but with normal measurements of the umbilical artery S/D ratio. Moreover, 69% of abnormally elevated umbilical artery S/D ratios were detected at or before 30 weeks' gestation. Calculation of an S/D ratio of the umbilical cord greater than the 95th percentile for gestational age is an early and sensitive predictor of poor perinatal outcome.
92名患有各种妊娠并发症的孕妇在确诊后接受了脐带多普勒超声检查。将收缩期与舒张期（S/D）比值的计算结果与宾夕法尼亚大学医院制定的孕周数值线图进行对比。孕周S/D比值高于第95百分位数可正确预测58%的子痫前期孕妇以及61%的小于胎龄儿（SGA）。在S/D比值升高的胎儿中，42%出现胎儿窘迫，其定义为胎儿心率异常、1分钟或5分钟阿氏评分分别低于5分或7分，或脐血pH值测定低于7.20；60%需要手术分娩；49%住院时间超过5天或被收入新生儿重症监护病房（NICU）。所有这些数值均显著高于无并发症妊娠对照组或妊娠情况相似但脐动脉S/D比值测量正常的女性组。此外，69%的脐动脉S/D比值异常升高在孕30周及以前被检测到。计算孕周S/D比值高于第95百分位数是围产期不良结局的早期敏感预测指标。
