| Backgroud:Fetal distress is the direct cause of neonatal asphyxia,also is the main complications for perinatal death and damage to the nervous system of children.About the diagnosis of human fetal distress is only theoretical inference, which is not the "gold standard" of diagnosis in existence in the clinica.Many scholars have already proposed that the common prediction of fetal distress has a high clinical value if we combined with umbilical cord blood flow and fetal monitoring.In this study, we combined the three indicators to study fetal distress,including color Doppler imaging,fetal monitoring and the uterine spiral artery of morphologic changes of placental basal decidua,that make the diagnosis of fetal distress more clearly.Purpose:Using the Color Doppler to detect the uterine spiral arteries,we analyzed the relationship between the fetal distress and the uterine spiral artery blood flow changes in mechanical parameters,that could provide an effective means in judging and forecasting the occurrence of fetal distress.Besides,we combined with Color Doppler and histomorphology of placenta,assessed the fetal distress from Physiopathology,so as to provide a reliable method and an important basis to more in-depth research.Methods" We applied of color Doppler ultrasound to detect uterine spiral arteries of the patient in our hospital's who are 100 cases of full-term normal pregnant women and 58 cases of high-risk pregnant women without any pre-treatment,so as to gain 3-5 clear Doppler spectrum.We calculated the pulsatility index(PI),the resistence index(RI),the ratio of peak systolic flow velocity and end diastolic flow velocity(S/D) automatically through the instrument,then recorded and analyzed the results.The fetal heart rate monitoring in pregnant women were did non-stress test(NST) within 24-48 hours after ultrasonography,the Kreb's scores were recorded.We accessed the placental basal decidua of pregnant women after they deliveried,then the changes of organization in placental basal decidua were observed under the microscope,and record neonatal Apgar score.We analyzed the relevance between the blood flow of the uterine spiral arteries and the fetal distress.Results:â‘ The hemodynamics parameters of uterine spiral artery:The PI, RI,S/D in fetal distress group are higer than that in the control group,that has a significant statistical difference(P<0.01).â‘¡The fetal distress is correlation with the hemodynamic abnormalities of uterine spiral artery(P<0.01);The fetal distress is correlation with fetal heart rate monitoring abnormalities(P<0.01)â‘¢The changes of histomorphology in spiral arteries of placental basal decidua:spiral artery wall in fetal distress group is thicker,bureaucratic is narrower than that in the control group.The incidence of Placental pathological change in fetal distress group is higher than that in the control group,that has a significant statistical difference(P<0.01).The fetal distress is correlation with the changes of histomorphology in the uterine spiral artery (P<0.01).â‘£We can' t think that the changes of histomorphology in the uterine spiral artery is correlation with perinatal prognosis(P>0.05).Conclusion:â‘ The blood flow of uterine spiral artery detected by Color Doppler ultrasound can predict the occurrence of fetal distress.â‘¡The changes of histomorphology in the uterine spiral artery are the basic of pathophysiology which is the hemodynamic changes in the placenta when fetal distress.The lumen of the uterine spiral arteries become narrower,the flow resistance become increaser,that impacts the blood perfusion of placenta.Ischemia and hypoxia in placenta,effects the fetal oxygen supply,resulting in the occurrence of fetal distress.â‘¢Fetal intrauterine situation is correlation with uterine spiral artery hemodynamics parameters and fetal heart rate monitoring.â‘£The sensitivity and the specificity of diagnosis by uterine spiral artery blood flow are higher than the fetal heart rate monitoring. |
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