子痫前期脐血流异常与围生儿预后相关性分析

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1、子痫前期脐血流异常与围生儿预后相关性分析作者：李寒松李炜王少为王少为【摘要】目的探讨子痫前期患者脐动脉血流改变与围生儿预后的相关性。方法回顾性分析2006年1月至2009年6月在本院产前检查至分娩的92例子痫前期患者的脐动脉血流参数S/D值、血流波动指数(PI)、阻力指数(RI)及新生儿出生时体重、Apgar评分、胎盘重量等的变化。92例患者中轻度子痫前期57例、重度子痫前期35例。随机选择同期正常妊娠分娩、无产科并发症及合并症的100例患者作为正常对照组，观察S/D、PI、RI值及母婴结局。结果随着子痫前期病情严重程度的增加，

2、S/D、PI、RI值均呈增高趋势，重度子痫前期组脐血流参数明显高于正常组，差异有统计学意义(P<0.01);轻度子痫前期组与正常组比较增高趋势不明显，差异无统计学意义(P>0.05)。随着脐血流参数的增加，重度子痫前期的新生儿出生时平均体重、Apgar评分、胎盘重量均低于正常组，差异有统计学意义(P<0.01)。脐血流异常的重度子痫前期患者的胎儿生长受限发生率、围生儿死亡率明显高于正常对照组，差异有统计学意义(P<0.01);轻度子痫前期组的上述变化与正常对照组比较，差异无统计学意义。结论重度子痫前期脐血

3、流参数S/D、PI、RI值可以作为判断胎儿宫内状况的指标，为胎儿预后提供了简易无创的监测手段。11【关键词】子痫前期;彩色多普勒超声;脐动脉血流比值;围生儿预后　　【Abstract】ObjectiveToinvestigatetherelationshipbetweenumbilicalbloodflowchangesandthepregnancyoutcomesamongwomenwithpreeclampsia.MethodsTherewere92preeclampsiapatientsinthedepartmentofo

4、bstetricsinourhospitalfromJanuary2006toJune2009.ParametersofumbilicalarterialbloodflowincludingS/Dratio,pulsatilityindex(PI),resistanceindex(RI),theaveragebirthweight,Apgarscoreandplacentalweightchangeswereanalyzedretrospectivelyin92preeclampsiapatients(including57mi

5、ldand35severecases)and100womenwithnormalpregnancyasthecontrolgroup.ResultsTheumbilicalarterialbloodflowparameterstendedtoincreasewiththeseverityofpreeclampsia,andthevaluesoftheseparametersweresignificantlyhigherinpatientswithseverepreeclampsiathaninthecontrolgroup(P&

6、lt;0.01),althoughnosignificantdifferenceswereobservedbetweenthemildpreeclampsiagroupandthecontrolgroup(P>0.05).Themeanbirthweightofthenewborns,Apgarscores,andplacentalweightweresignificantlylower(P<0.01),andtheincidenceoffetalgrowthrestrictionandperinatalmortal

7、ityweresignificantly11higherintheseverepreeclampsiagroupthaninthecontrolgroup(P<0.01).Nosignificantdifferenceswerefoundintheseparametersbetweenthemildpreeclampsiagroupandthecontrolgroups(P>0.05).ConclusionUmbilicalarterybloodflowparametersasindicatorsfordetermi

8、ningthefetalstatuscanbeusedtopredictpregnancyoutcomesofseverepreeclampsia.　　【Keywords】Preeclampsia;ColorDopplerultrasonography;Umbi