摘要
目的探讨孕晚期彩色多普勒超声血流参数异常原因及对妊娠结局的影响。方法选择2014年10月至2016年12月南京江北人民医院孕晚期彩色多普勒超声血流参数异常孕妇59例(研究组),年龄22~39岁,平均年龄30.41岁;体质量58~69 kg,平均体质量63.30 kg;孕周37~42周,平均孕周39.04周。另选择同期孕晚期彩色多普勒超声血流参数正常孕妇59例为对照组,年龄21~41岁,平均年龄30.87岁;体质量56~70 kg,平均体质量62.89;孕周36~42周,平均孕周38.94周。两组均接受彩色多普勒超声检查,统计分析孕晚期彩色多普勒超声血流参数异常原因及不良妊娠结局发生率(羊水污染、胎儿宫内窘迫、剖宫产、Apgar分值≤7)。结果研究组孕晚期彩色多普勒超声血流参数异常原因发生率脐带扭转为15.25%,脐带绕颈为35.59%,糖尿病为13.56%,妊娠期高血压为25.42%,胎儿宫内发育迟缓为16.95%,胎儿畸形为13.56%,对照组分别1.69%、8.47%、1.69%、10.17%、0.00%、0.00%;两组比较,研究组各指标发生率较对照组高,差异有统计学意义(P<0.05)。脐带扭转、脐带绕颈、糖尿病、妊娠期高血压、胎儿宫内发育迟缓、胎儿畸形均为孕晚期彩色多普勒超声血流参数异常的重要影响因素(P<0.05);脐带扭转、脐带绕颈、糖尿病、妊娠期高血压、胎儿宫内发育迟缓、胎儿畸形均与孕晚期彩色多普勒超声血流参数异常呈明显正相关性(P<0.05)。研究组不良妊娠结局发生率羊水污染为18.64%,胎儿宫内窘迫为33.90%,剖宫产为72.88%,Apgar分值≤7为64.41%,对照组分别为3.39%、10.17%、20.34%、3.39%;两组比较,研究组各指标发生率较对照组高,差异有统计学意义(P<0.05)。结论脐带扭转、脐带绕颈等均是导致孕晚期彩色多普勒超声血流参数异常的重要原因,其能增加不良妊娠结局发生风险,因此应通过彩色多普勒超声对孕妇进行检查,并及时采取对应措施处理血流参数异常原因,对改善妊娠结局具有一定积极意义。
Objective To investigate the causes of abnormal blood flow parameters of color Doppler ultrasonography in late pregnancy and its effect on pregnancy outcome. Methods From October 2014 to December 2016, 59 late pregnant women with abnormal blood flow parameters of color Doppler ultrasonography were enrolled as study group（aged 22-39 years old with mean age of 30.41 years old; body weight was 58-69 kg with mean body weight of 63.30 kg; gestational aged 37-42 weeks with mean gestational age of 39.04 weeks）, and 59 late pregnant women with normal blood flow parameters of color Doppler ultrasonography were set as control group（aged 21-41 years old with mean age of 30.87 years old; body weight was 56-70 kg with mean of 62.89 kg; gestational aged 36-42 weeks with mean of 38.94 weeks）. All of them were performed by color Doppler ultrasonography, the abnormal outcome of color Doppler ultrasonography and incidence of adverse pregnancy outcome（amniotic fluid pollution, fetal distress, cesarean section, Apgar scores ≤ 7） were analyzed. Results The incidence of abnormal blood flow parameters by color Doppler ultrasonography in study group and control group as follows： umbilical cord torsion（15.25 % vs 1.69 %）, umbilical cord around neck（35.59 % vs 8.47 %）, diabetes（13.56 % vs 1.69 %）, gestational hypertension（25.42 % vs 10.17 %）, intrauterine growth retardation（16.95 % vs 0.00 %） and fetal malformations（13.56 % vs 0.00 %）, the incidence of each index in study group was higher than that of control group, and difference was statistically significant（ P〈0.05）; The umbilical cord torsion, umbilical cord around neck, diabetes, gestational hypertension, fetal intrauterine growth retardation and fetal malformations were important factors of abnormal color Doppler ultrasound parameters（ P〈0.05）; There were significant positive correlations between umbilical cord torsion, umbilical cord around neck, diabetes mellitus, gestational hypertension, fetal intrauterine growth retardation, fetal malformation and abnormal blood flow parameters of color Doppler ultrasonography（P〈0.05）; The incidence of adverse pregnancy outcomes in study group and control group： amniotic fluid pollution（18.64 % vs 3.39 %）, intrauterine distress（33.90 % vs 10.17 %）, cesarean section（72.88 % vs 20.34 %）, Apgar scores ≤7（64.41 % vs 3.39 %）, the incidence of each index in study group was higher than that of control group, and difference was statistically significant（P〈0.05）. Conclusion It is demonstrated that umbilical cord torsion, umbilical cord around neck are important reasons to abnormal blood flow parameters of color Doppler ultrasonography in late pregnancy, which could increase the risk of adverse pregnancy. So pregnant women should be checked by color Doppler ultrasound and timely treatment of abnormal blood flow parameters, and it has the certain positive significance to improve the pregnancy outcome.
作者
沈萍
龚兆萍
汪敏
SHEN Ping,GONG Zhao-ping,WANG Min(Department of Ultrasonography, Nanjing Jiangbei People＇s Hospital, Nanjing 210048, Jiangsu, Chin)
出处
《生物医学工程与临床》
CAS
2018年第2期159-163,共5页
Biomedical Engineering and Clinical Medicine
关键词
孕晚期
彩色多普勒超声血流参数
异常原因
妊娠结局
late pregnancy
color Doppler ultrasound blood flow parameters
abnormal causes
pregnancy outcome
