Clinical Application Research Of Placental Vascular And Middle Cerebral Artery Blood Flow Monitoring In Fetal Growth Restriction

ObjectionFetal growth restriction is one of the serious complications of obstetrics which is also an important cause of perinatal death.At present,the etiology is not yet clear.The etiology of fetal growth restriction is divided into four categories:maternal factors,placental factors,umbilical cord factors and fetal factors.Insufficient placental perfusion in placental factors is the most important cause of placental dysfunction and is the leading cause of FGR.In clinical practice,the way through color Doppler ultrasound monitor uterine arterial blood flow or umbilical arterial blood indirectly before delivery to assess the placental function is used most.No studies have reported that using the hemodynamic status of placenta vessels directly to assess the placental function.Using prospective analysis of research methods to investigate the value of placental blood vessels in the diagnosis of FGR and evaluation the treatment effection of FGR patients.In order to provide the reference comment for the early finding,early diagnosis and early treatment of fetal growth restriction and prevent perinatal death and improve the prognosis of the newborn.Methods1.Subjects:The data was collected from January 2015 to December 2017,the pregnant women who had undergone regular production inspection and delivered in our hospital.And it was divided into two groups according ultrasound inspection results,including 57 patients in the control group and 80 patients in the FGR group.Both groups were divided into three groups according to gestational age:28-31⁺⁶ weeks of gestation,32-36⁺⁶ weeks of gestation,and 37-40 weeks of gestation.The FGR group was divided into two groups according to whether it was treated:FGR treatment group and FGR untreated group.2.FGR diagnostic criteria:During pregnancy,the ultrasound monitoring found that the fetal weight was lower than the 10th percentile of the mean weight of the corresponding gestational age or 2 standard deviations below its mean weight,or the fetal weight was less than 2500 g after 37 weeks of gestation.3.Methods:A prospective analysis was used to compare placental blood flow,middle cerebral artery blood flow,and Cerebro-placental ratio between the two groups of women.SPSS 21.0 was used for statistical analysis of the data.Results1.In general comparison,there was no statistically significant difference in age and pregnancy between the FGR group and the control group.2.The S/D,PI and RI values of placental blood vessels and middle cerebral artery blood vessels in the control group and FGR group showed a decreasing trend with the increase of gestational age.3.S/D,PI and RI values of placental blood vessels in the untreated group were significantly higher than those in the control group?P<0.05?.4.At 28-31⁺66 weeks of gestation and 32-36⁺⁶ weeks of gestation,S/D,PI,RI,and cerebral placenta ratio?CPR?of placental secondary vessels blood flow were used to predict FGR,with the highest AUC values.5.The S/D,PI and RI values of umbilical blood flow in FGR-treated group were significantly lower than those in FGR-untreated group at 32-36⁺⁶ weeks of gestation?P<0.05?.There was no significant difference in S/D and PI of placental tertiary vessels blood vessels?P>0.05?.6.The blood flow index of placental blood vessels in the FGR treatment group was higher than that in the control group after 37 weeks of pregnancy?P<0.05?.There was no significant difference between the middle cerebral artery and the cerebro-placental ratio index between the two groups?P<0.05?.Conclusions1.The sensitivity of FGR in different gestational ages is different between placental vessels and middle cerebral artery blood flow indicators and brain placenta rate.2.Monitoring of placental secondary vessels and placental tertiary vessels blood flow indicators can directly assess the status of placental blood circulation,and have more advantages in the diagnosis of FGR.It can be used to clinically diagnose FGR and guide treatment.3.Placenta grade 3 blood vessels have advantages in assessing the therapeutic effects of FGR patients.