Value Of Doppler Ultrasound Detection Of Middle Cerebral Artery And Umbilical Artery For Intrauterine Hypoxia In The Fetus

[Objectives]The purpose of this study was to investigate the use of Doppler ultrasound to detect the relevant blood flow parameters of middle cerebral artery and umbilical artery of fetuses in late pregnancy,and to study the value of its single application and combined application in the evaluation of fetal intrauterine hypoxia,in order to improve the accuracy of clinical diagnosis of fetal intrauterine hypoxia.[Methods]From Sept.2021 to Dec.2022,160 pregnant women with singleton pregnancies,aged 18 to 46 years and 28 to 40 weeks of gestation,who underwent antenatal checkups and delivered in our hospital were selected for the study.80 pregnant women with fetal hypoxia were considered as the hypoxic group,and 80 pregnant women with healthy pregnancies in the same period were considered as the natural group.Doppler ultrasound was applied to detect the blood flow parameters of umbilical artery（UA）and middle cerebral artery（MCA）in both groups:the ratio of peak systolic velocity to end-diastolic velocity（S/D）,resistance index（RI）and pulsatility index（PI）,and the ratio of the middle cerebral artery to each of the above blood flow parameter indexes of UA was calculated to analyze the value of each index in assessing intrauterine hypoxia of fetus[Results]1 The fetal umbilical artery flow parameters in the hypoxic group:S/D,RI,PI were higher than the natural group,and there was a remarkable difference between the two groups（P<0.001）.2.The blood flow parameters of fetal middle cerebral artery in the hypoxic group:S/D,RI,PI were less than the natural group,and there was a clear difference between the two groups（P<0.001）.3.The combined indicators of blood flow parameters:[(S/DMAC)/（S/D）_UA,RI_MAC/RI_UA,PI_MAC/PI_UA]were reduced in the fetus in the hypoxic group compared to normal,with a meaningful difference between the two groups at P<0.001.4.The area under the AUC curve and Youden index were both generally above those of the combined index compared to the single measure,which shows that the combined index had a better ability to predict hypoxia than the single measure.5.The incidence of adverse pregnancy outcomes in the fetus of the hypoxic group was 86.05%,which was much higher than that of the natural group（36.75%）,and the discrepancy between the two groups was considered statistically significant（P<0.001）.[Conclusions]1.Doppler ultrasound detection of changes in hemodynamic parameters of the fetal umbilical artery and the middle cerebral artery is valuable in assessing intrauterine fetal conditions and predicting the outcome of adverse pregnancies.2.When fetuses suffer from intrauterine hypoxia,the S/D,RI and PI of UA are higher than those of normal fetuses,while the S/D,RI and PI of MCA are decreased than those of healthy fetuses.This change can be used to judge the situation of fetal intrauterine hypoxia.3.The combined detection of the S/D,RI and PI of the hemodynamic parameters of the UA and the MCA can improve the accuracy of diagnosis,which is of great significance and value for guiding the follow-up clinical treatment and improving the quality of eugenic and eugenic care.