关键词: 超声检查, 多普勒, 彩色, 超声检查, 产前, 胎儿缺氧, 胎儿, 敏感性与特异性, 脐动脉, 大脑中动脉, 血流 指数

Abstract: Abstract: Objective To evaluate the clinical value of Doppler ultrasonography in the diagnosis of fetal intrauterine hypoxia in different gestational weeks of late pregnancy. Methods From January 2016 to December 2016, 1 017 neonates without intrauterine hypoxia (normal group, including 347 cases of 28-31+6 weeks, 360 cases of 32-36+6 weeks, 310 cases of 37-41+6 weeks) and 218 neonates with intrauterine hypoxia (hypoxia group, including 47 cases of 28-31+6 weeks, 82 cases of 32-36+6 weeks, 89 cases of 37-41+6 weeks) were subjected to a prenatal examination and hospital delivery at 28-41+6 weeks in our hospital. The colour Doppler ultrasound was used to detect hemodynamic index of umbilical artery (UA) and middle ce⁃ rebral artery (MCA), including resistance index (RI), pulsation index (PI) and systolic peak velocity diastolic velocity ratio (S/ D) in the prenatal stage in all subjects. Results (1) The UA blood flow parameters decreased with the increase of gestation⁃ al age in late pregnancy without intrauterine anoxia. With UA-S/D>3.0 as diagnostic criteria, the fetal hypoxia specificities were 94% and 99% for 32-36+6 weeks and 37-41+6 weeks, but the fetal hypoxia specificity was 67% for the diagnosis of 28- 31+6 weeks. (2) The blood flow parameters of MCA decreased with the increase of gestational age, and which was decreased significantly over the full pregnancy term in late pregnancy without intrauterine anoxia. MCA-RI<0.6, PI<1.6 and S/D<4.0 were used as criteria for the diagnosis of intrauterine fetal hypoxia, the fetal hypoxia specificities were 99% and 98% in 28- 31+6 weeks and 32-36+6 weeks. However, the specificity of fetal hypoxia was only 24% in 37-41+6 weeks. (3) In the late preg⁃ nancy, UA blood flow parameters were significantly increased, and the blood flow parameters of MCA were significantly re⁃ duced in intrauterine hypoxia fetal. The UA-S/D>3.28 was used as the standard to diagnose the intrauterine hypoxia in 28- 31+6 weeks, Youden index increased to 0.76. The MCA index showed no diagnostic significance for intrauterine hypoxia in full-term pregnancy. Conclusion The hemodynamic parameters of UA and MCA have their own changing rules in late pregnancy at different gestational weeks, which should be combined with the diagnosis to improve the diagnostic accuracy of intrauterine hypoxia.

Key words: ultrasonography, doppler, color, ultrasonography, prenatal, fetal hypoxia, fetus, sensitivity and specificity, umbilical arteries, middle cerebral artery, flow index