| Objective:To investigate the hemodynamic changes of the umbilical cord around neck Fetus' umbilical artery(UA)and middle cerebral artery(MCA);to evaluate the prognosis of perinatal children,to evaluate the use value of color Doppler flow imaging in predicting intrauterine hypoxia and perinatal clinical outcomes.Methods:Our some objects of observation are pregnant women from Shanxi Grand Hospital during May 2016 and December 2016.They were examined by ultrasound in our hospital and confirmed as the umbilical cord around the neck,singleton,the first bit of fetal pregnant women.Our objects of study are 97 cases of umbilical cord around the neck of the fetus whoes gestational age are in 37 ~ 41+6 weeks in our hospital.The color Doppler ultrasound confirmed their umbilical cord are around the necks.After that,we do some no stress tests.And then according to fetal heart rate monitoring,we determine hypoxia or not(RI,PI,S / D).They were devided into two groups: hypoxia group(38 cases)and no hypoxia group(59 cases).And then measure the umbilical artery and arterial blood flow in the brain mechanics index(RI,PI,S/D),and track postpartum amniotic fluid properties,heart rate changes and delivery modes during the process of trial production,etc.Results:The hemodynamic index of umbilical artery in hypoxia group was significantlyhigher than that in non hypoxia group,and the hemodynamics index of middle cerebral artery was significantly lower than that of non hypoxia group(P <0.05).(S / D)was(3.24 ± 0.04),the umbilical artery blood flow resistance index RI was(0.77 ± 0.06),and the umbilical artery pulsatility index PI(P <0.05)was significantly higher than that in the control group(P <0.05)(1.70 ± 1.71),the ratio of peak systolic velocity and end diastolic blood flow velocity(S / D)was(3.28 ± 0.18),middle cerebral artery resistance index(0.60 ± 0.04),brain(1.49 ± 0.10),amniotic fluid pollution rate was 47.36%(18/38),the abnormal rate of fetal heart rate was 55.26%(21/38),and the rate of cesarean section was42.10%(16/38).(S / D)was(2.27 ± 0.07),the umbilical artery resistance index(RI)was(0.51 ± 0.04),and the umbilical artery pulsatility index(PI)was(P <0.05),and the ratio of systolic blood flow velocity to systolic velocity(1.80 ± 0.33),middle cerebral artery systolic peak blood flow velocity and end diastolic blood flow velocity(S / D)was(4.78± 0.14),middle cerebral artery resistance index RI was(0.82 ± 0.03)Arterial pulsatility index PI(1.75 ± 0.03),amniotic fluid pollution rate 18.64%(11/59),vaginal test fetal heart rate 2 2.03%(13/59),cesarean section rate of 15.25%(9/59),the difference was statistically significant(all P <0.05).Conclusion:1.UA-RI,UA-PI,MCA-RI,MCA-S / D,MCA-PI and amniotic fluid pollution were used to evaluate the intrauterine safety status and neonatal birth Clinical reference value.2.Color Doppler ultrasonography is sensitive,simple and safe in examining the changes of umbilical cord blood flow around the neck,and it provides accurate and abundant information,which can provide a quantitative basis for clinicians to further diagnosis and treatment of patients.3.Timely and rational use of color Doppler ultrasound on the umbilical cord around the middle cerebral artery and umbilical artery blood flow joint monitoring,can be more comprehensive and objective evaluation of fetal intrauterine situation,so as to betterserve the clinical. |
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