| Objective To study the difference of blood flow parameters of umbilical artery,middle cerebral artery and venous catheter between FGR fetus and normal fetus,and to compare the pregnancy outcome and perinatal period between the two groups.Methods The pregnant women of 32w-40w from January 2019 to December 2019 were selected as the research objects.67 FGR pregnant women confirmed by clinical and ultrasound were set as case group,75 normal pregnant women confirmed by clinical and ultrasound were set as control group.To compare the differences of multi vessel and multi blood flow parameters between the two groups of umbilical artery(UA),middle cerebral artery(MCA),venous catheter(DV).The indexes of umbilical artery and middle cerebral artery included pulse index(PI),resistance index(RI),peak systolic velocity/end diastolic velocity(S/D),and systolic maximum velocity Peak systolic velocity(PSV),The ratio of PI of middle cerebral artery to that of umbilicus artery was calculated.The indexes of venous catheter included ventricular systole wave(S),atrial systole wave(a)and S/a ratio.The results of pregnancy and perinatal period of the two groups were compared,including the rate of neonatal asphyxia,the rate of low birth weight,the rate of premature delivery,the rate of postpartum hemorrhage and the Apgar score of the two groups after birth.Statistical methods were processed by SPSS 20.0,measurement data were expressed by(x±s),group comparison by t-test,count data by(n,%),and chi-square test.All statistical results were p<0.05,indicating that the difference was statistically significant.The area under ROC curve(AUC),diagnostic sensitivity,specificity and Youden index were calculated by receiver operating characteristic curve(ROC),and the blood flow parameters of UA,MCA,CPR and DV were evaluated respectively and jointly to diagnose FGR.Result ?PI,RI and S/D of fetal umbilical artery in case group were higher than those in control group,the difference was statistically significant(P<0.01).?PI,RI and S/D of middle cerebral artery in case group were lower than those in control group,the difference was statistically significant(P<0.01)?There was no significant difference in fetal umbilical artery PSV and middle cerebral artery PSV between the case group and the control group(P>0.05).?The CPR of the case group was lower than that of the control group(P<0.01).?The velocity of S peak and a wave of fetal venous catheter in case group was lower than that in control group,and the ratio of S/a was higher than that in control group(P<0.01).?The diagnosis efficiency was calculated by ROC.The diagnosis efficiency of MCA and CPR is higher for single index.The diagnostic efficiency of combined application is the highest?The results showed-that the asphyxia rate and low birth weight rate in the case group were significantly higher than those in the control group(P<0.01).?There was no significant difference in the rate of premature delivery and postpartum hemorrhage between the two groups(P>0.05).?Comparison of Apgar scores between two groups,lower in case group than in control group,the difference was statistically significant(P<0.01).Conclusion The comprehensive evaluation of multi vessel and multi blood flow parameters of color Doppler ultrasound plays an important role in monitoring FGR fetal status in the uterus.The abnormal degree of the indexes is closely related to the degree of intrauterine growth restriction,which has a high clinical value.It can be used as a sensitive index of FGR fetal monitoring in the late pregnancy and provide important help for the clinical.The importance of comprehensive evaluation of multi vessel and multi blood flow parameters for FGR fetus was emphasized.The importance of comprehensive evaluation of multi vessel and multi blood flow parameters for FGR fetus is emphasized.Timely intervention in case of abnormal indexes can significantly improve perinatal outcome and neonatal quality. |
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