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目的 探讨超声监测胎儿大脑中动脉血流对足月妊娠胎儿缺氧的预测。方法 对191例足月妊娠孕妇进行超声检查,根据结果分为3组,A组:脐动脉血流监测S/D比值>3.0、RI>0.67、PI>1.0,共计32例;B组:胎儿大脑中动脉血流监测S/D比值<4.0、RI<0.6、PI<1.6,共计29例;C组:脐动脉血流及大脑中动脉血流比值(UAPI/MCAPI)>1.00、(UAS/UAD)/(MCAS/MCAD)>0.60、(UARI/MCARI)>1.00,共计12例。观察各组新生儿出生窒息情况。结果 3组新生儿窒息1分钟为A组16例占50%(16/32);B组15例占51.7%(15/29);C组11例占91.7%(11/12),差异有显著性(P<0.05);5分钟为A组5例占15.6%(5/32);B组6例占20.7%(6/29);C组6例占50.0%(6/12),差异有显著性(P<0.05)。结论 超声监测胎儿大脑中动脉血流能准确预测胎儿宫内缺氧情况;与脐动脉血流比值,能较早识别重度缺氧患者,提请临床关注。
Objective To evaluate the value of monitoring fetal middle cerebral artery in forecasting intrauterine fetal hypoxia by using Color Doppler ultrasonography. Method Ultrasonography was used to monitor191 fetuses in late pregnancy. The patient are divided into three groups, there are 32 patients in group A with S/D>3.0,RI>0.67,PI>1.0 according to the monitoring umbilical artery blood flow. There are 29 patients in group B with S/D<4,RI<0.6,PI<1.6 according to the monitoring fetal middle cerebral artery flow. There are 12 patients in group C with(UAPI/MCAPI)>1.00,(UAS/UAD)/(MCAS/MCAD)>0.60,(UARI/MCARI)>1.00 according to the monitoring both umbilical artery blood flow and fetal middle cerebral artery flow. Observe the rate of neonatal asphyxia in the three groups. Results The rate of neonatal asphyxia in one minute by Apgar is 50%、15%、91.7% in the three groups, these have significant differences. The rate of neonatal asphyxia in five minutes by Apgar is 15.6%、20.7%、50.0% in the three groups, these also have significant differences. Conclusions Monitoring fetal middle cerebral artery is valuable in forecasting intrauterine fetal hypoxia and more earlier than the umbilical artery blood flow. We should pay more attention to it.
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