论文部分内容阅读
目的 应用彩色多普勒超声研究脐动脉舒张末期血流缺如(absent end diastolic velocity,AEDV)的胎儿心脏和外周血液动力学的变化,并与胎心率电子监护相比较,了解两者间的关系及围产儿结局。 方法 应用彩色多普勒超声技术对 27 例 AEDV胎儿心脏水平(主动脉、肺动脉)和外周血管(脐动脉、大脑中动脉)的最大血流速度波形进行分析,与胎心率电子监护结合,随访围产儿预后。 结果 27例均表现肺动脉明显收缩,其流速积分(VTI)×胎心率(FHR)和右心输出量明显下降。27例中22例进行动态观测的病例中10例仅有大脑中动脉搏动指数(MCA PI)下降而没有左心输出量的明显改变;12例有MCA PI先降低,后上升两阶段改变,最后伴有主动脉 VTI×FHR、左心输出量的显著减少。发现AEDV和出现胎心率异常的间隔时间是2~17 d。 结论 胎儿缺氧时脐血流AEDV可能早于胎心监护异常,AEDV一旦诊断应立即终止妊娠,如出现 MCA PI升高或左心输出量的显著减少后终止妊娠,围产儿的病率和死亡率可能明显升高。
Objective To study the changes of fetal heart and peripheral hemodynamics in umbilical artery with end-diastolic velocity (AEDV) by color Doppler ultrasonography and compare with the fetal heart rate electronic monitoring Relationship and perinatal outcome. Methods The color Doppler ultrasound was used to analyze the maximum blood flow velocity waveform in 27 AEDV fetal heart (aorta and pulmonary artery) and peripheral blood vessels (umbilical artery and middle cerebral artery), and was combined with electronic monitoring of fetal heart rate Perinatal outcome. Results All of the 27 cases showed significant pulmonary artery constriction, and the velocity integral (VTI) × fetal heart rate (FHR) and right ventricular output decreased significantly. Among the 22 cases of dynamic observation, only 10 cases of MCA PI decreased without obvious change of left ventricular output. Of the 12 cases, MCA PI decreased first and then increased two stages, and finally Accompanied by aortic VTI × FHR, a significant reduction in left ventricular output. Found AEDV and fetal heart rate abnormalities interval is 2 ~ 17 d. Conclusions AEDV of fetal umbilical cord blood flow may be earlier than fetal monitoring abnormality in fetal hypoxia. AEDV should terminate the pregnancy immediately upon diagnosis, such as termination of pregnancy after a significant decrease in MCA PI or left ventricular output, and the prevalence and mortality of perinatal Rate may be significantly higher.