摘要: |
目的 比较脐动脉监测、胎心监护和胎儿生物物理行为在子痫前期胎儿监测中的应用价值,探讨子痫前期新生儿不良结局的预测指标。方法 收集分娩前一周内行脐动脉、胎心监护、超声生物物理评分、生物物理评分和改良生物物理评分(MBPP)检查的123例子痫前期单胎孕妇及其新生儿结局资料,对上述监测结果均进行分组比较,并寻找预测新生儿不良结局的相关指标。结果 与脐动脉正常组比较,脐动脉舒张末期血流缺失或反向(UA-AREDV)组新生儿不良结局发生率增高(P<0.01);与胎心监护正常组比较,异常NST(或Ⅲ类图形)组新生儿不良结局发生率增高(P<0.01);与MBPP正常组比较,MBPP异常组新生儿不良结局发生率增高(P<0.05)。UA-AREDV、异常NST(或Ⅲ类图形)预测子痫前期新生儿不良结局的诊断比值比分别为18.4和5.9。UA-AREDV诊断新生儿不良结局的阳性预测值和阴性预测值为82.1%和81.0%;异常NST(或Ⅲ类图形)诊断新生儿不良结局的阳性预测值和阴性预测值为72.2%和73.3%。结论 子痫前期胎儿宫内监测指标较多,其中脐动脉、胎心监护和MBPP更有优势,UA-AREDV和异常NST(或Ⅲ类图形)对新生儿不良结局具有较好的预测价值。 |
关键词: 超声检查;脐动脉监测 胎心监护 改良生物物理评分 子痫前期 新生儿不良结局 |
DOI: |
投稿时间:2020-12-03修订日期:2021-03-03 |
基金项目: |
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A comparative study of fetal intrauterine monitoring methods for predictingadverse neonatal outcomes with preeclampsia |
Wang Yali,Wu Qingqing,Zhang Lina |
(Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital,Capital Medical University) |
Abstract: |
Objective To compare the application value of umbilical artery,electronic fetal monitoring and fetal biophysical behaviors and to explore the predictors of adverse neonatal outcomes in the patients with preeclampsia. Methods A total of 123 singleton pregnant women with preeclampsia who underwent umbilical artery electronic fetal monitoring,ultrasonographic biophysical profile,biophysical profile,modified biophysical profile(MBPP)were selected. The results of the five kinds of monitor methods within one week before delivery and neonatal outcomes were recorded. The data of every monitor methods were grouped and compared,to find out the predictive factors of adverse neonatal outcomes. Results The incidence of adverse neonatal outcomes was higher in the group with absent or reversed end diastolic velocity of the umbilical artery(UA-AREDV)compared with the normal umbilical artery group(P<0.01);the incidence of adverse neonatal outcomes was higher in the group with abnormal NST (or type III figure)compared with the normal electronic fetal monitoring group (P<0.01);the incidence of adverse neonatal outcomes was higher in the group with abnormal MBPP scores compared with the normal scores group(P<0.05).The diagnostic odds ratios of UA-AREDV and abnormal NST (or type III figure) were 18.4 and 5.9 respectively in predicting adverse neonatal outcomes of patients with preeclampsia. The positive predictive value and negative predictive value of UA-AREDV were 82.1% and 81% and the positive predictive value and negative predictive value of abnormal NST (or type III figure) were 72.2% and 73.3% in the diagnosis of adverse neonatal outcomes. Conclusion There are many indexes of fetal intrauterine monitor in the pregnant women with preeclampsia. umbilical artery,electronic fetal monitoring and MBPP are profit.UA-AREDV and abnormal NST (or type III figure) are valuable in predicting neonatal adverse outcomes. |
Key words: Ultrasonography Umbilical artery Electronic fetal monitoring Modified biophysical profile preeclampsia Adverse neonatal outcomes |