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目的探讨胎儿大脑中动脉血流阻力指数(MCA-RI)在临产前后的变化及其对产时胎儿宫内缺氧的预测价值。方法运用超声多普勒检测200例孕足月低危妊娠胎儿的MCA-RI。将临产前最后一次检测与临产后潜伏期所测值进行比较,分析其下降情况与产时胎儿宫内窘迫的相关性。结果所有检测对象临产前MCA-RI值全部处于正常范围(0.68±0.051),与临产后(0.66±0.058)差异有统计学意义(t=5.145,P<0.05);其中67例临产后MCA-RI值较临产前明显下降(下降幅度>0.05),其胎儿宫内窘迫手术产率、产时异常胎心发生率分别为29.8%、49.2%,较无明显下降者明显增高,差异有统计学意义(χ~2=11.6、19.7,P<0.05)。结论在临产前无明显异常发现的低危妊娠胎儿在临产后部分存在MCA-RI值的明显下降;临产前后的MAC-RI下降变化与产时胎儿宫内窘迫的发生存在相关性,通过临产前后动态监测胎儿MCA-RI值的变化可能预测产时胎儿宫内窘的发生。
Objective To investigate the changes of fetal cerebral artery resistance index (MCA-RI) before and after labor and its predictive value of intrauterine fetal hypoxia. Methods Ultrasound Doppler was used to detect the MCA-RI in 200 fetuses with gestational low-risk pregnancies. The last test before labor and postpartum incubation period measured values were compared to analyze the relationship between decline and intrauterine fetal distress during delivery. Results All subjects had prenatal MCA-RI values within the normal range (0.68 ± 0.051) and postpartum (0.66 ± 0.058), respectively (t = 5.145, P <0.05) RI decreased significantly (P <0.05), and the rate of fetal distress surgery and abnormal fetal heart rate during labor were 29.8% and 49.2%, respectively, which were significantly higher than those without significant decrease Significance (χ ~ 2 = 11.6,19.7, P <0.05). Conclusions There is a significant decrease of MCA-RI value in low-risk fetus fetuses with no significant abnormality before labor. The decrease of MAC-RI before and after labor is correlated with the occurrence of intrauterine fetal distress during labor. Dynamic monitoring of fetal changes in the value of MCA-RI may predict the occurrence of intrauterine fetal distress during labor.