21三体胎儿的胎心率图型和脐动脉血流特征 [中文引用][英文引用]

目的 探讨21三体胎儿孕晚期的胎心率图型和脐动脉血流特征。方法  选择2007年1月至2010年8月期间在本院分娩出21三体儿的孕妇14例作为研究组，所有胎儿出生后行血染色体检查证实；同期收集分娩出正常儿的孕妇42例作为对照组，观察其胎心率监护结果和脐动脉血流收缩期峰速与舒张末期最低速度之比值(S/D值)。结果  研究组胎儿异常脐动脉S/D值发生率显著高于对照组，胎心率监护图型中基线异常的发生率显著高于对照组；无负荷试验无反应型或可疑型的发生率显著高于对照组。结论 在胎儿孕晚期的监护中，发现无反应型胎心率监护图型和脐动脉血流阻力增高，产科医生在考虑胎儿宫内窘迫的同时，必须高度警惕胎儿染色体异常，尤其是21三体异常。

Objective To evaluate the clinical significances of fetal heart rate patterns and umbilical artery flow velocity wave forms in pregnancies with trisomy 21. MethodThis was a prospective study including 14 fetuses with trisomy 21 and 42 normal fetuses in our institution. The fetal heart rate patterns and systolic/diastolic ratio (S/D) in the umbilical artery were analyzed, all cases were confirmed after born. ResultsThe S/D values of fetuses with trisomy 21 were higher than that of controls. More fetuses with trisomy 21 showed more abnormal FHR  patterns and decreased variability than control fetuses. Cesarean section deliveries that were based on fetal distress were performed more frequently in fetuses with trisomy 21 than in control fetuses. Conclusions The existence of abnormal FHR patterns and umbilical  artery flow resistance was not only the sign of fetal distress, but also alert the clinician for the possibility of underlying fetal chromosomal abnormalities.