The Effect Of Ultrasonic Monitoring Of Umbilical Artery Flow Velocity Waveforms In Prenatal Diagnosis About Fetal Malformation

Objective: To investigate the abnormalities of fetus in the morphology by examinating overally and carefully withⅠ,ⅡandⅢgrade levels of the ultrasonography. Meanwhile, the umbilical cord structure and the blood flow of umbilical artery were explored and recorded by ultrasound which to know diagnosised value and clinical significance of them in the fetal malformations. The post-labor fetal malformations were dissected to provide the morphological evidences of the pre-labor diagnosis.Methods: The fifty fetal malformations of induced terminated pregnancy were collected in out-patient and in-patient department of Gynecology and Obstetrics of the first affiliated hospital of He Nan scientific and technological University from Oct, 2008 to Aug, 2009, which were used as abnormal group. During this process, the seventy normal fetuses were also collected as control group. The average gestational weeks and pregnant women`s ages were (30±8.9) weeks and (28.5±10.4) ages respectively, meanwhile, the relevent clinical data of all pregnant women were collected. The groups of fetuses were divided according to random. The fetuses of abnormal group and control group were examinated byⅢgrade level of the ultrasonography and their blood flow waveforms of umbilical artery were also recorded. The induced fatal malformations were dissected.Results: 1. The age of abnormal group was evidently older than the control group, the difference was statistically significant (P<0.05).2. The systolic / diastolic (S/D) ratio of blood flow waveforms of umbilical artery in abnormal group was higher than the control group (P<0.001), the fetuses of absent end-diastolic flow (AEDF) or reversed end-diastolic flow (REDF) was higher incidence of the abnormalitily (75%).3. the eight fetuses were detected to have single umbilical artery all over the fetuses, the incidence of the abnormalitily was fifty percent in eight fetuses, but the S/D values of only one fetus increased, which implied the fetuses of normal blood flow waveforms of umbilical artery remainly may have malformations.4. The cases whose S/D values were abnormal in multi-malformations, urinary tract, cardiovascular system and the disease of skin and hypodermis, malformations groups are more than those in control group (P<0.05), there is no significant difference among central nervous system, gastrointestinal tract, skeleton-muscles system and control group (P>0.05).Conclusion: 1. The age of pregnant woman was old in fatal malformations, which implied the older the age of pregnant woman, the higher the incidence of fatal malformations.2. The increasing of S/D values had high clinical values in evaluating multi-malformations, urinary system, cardiovascular system and the diseases of skin and subcutaneous tissue. In the excluded maternal factors, the fetuses should be further examinated to exclude fatal malformations by ultrasound.3. The phenomenon of AEDF or REDF when it occurred would be used as a high risk indicator of fatal abnormal, the fetuses should be further examinated by ultrasound.4. The fetuses of single umbilical artery whether the blood flow waveforms of umbilical artery was or not was abnormal would be high incidence of fatal malformations.