Study On Evaluating Fetal Growth Restriction And Predicting The Pregnancy Prognosis By Color Doppler Ultrasonography In The Late Pregnancy

Objective Study on the value that evaluate fetal growth restriction(FGR) and predict the pregnancy prognosis by Doppler ultrasound examination on umbilical artery (UA)and middle cerebral artery(MCA) in the late pregnancy.Methods Use Color Doppler Flow Imaging(CDFI) technology to examine fetal UA and MCA flow waveforms in 106 fetuses whose gestatinal age range from 34 to 43 weeks, measure the hemodynamic parameters(UA and MCA PSV,EDV,RI,PI,S/D). By the routine antenatal ultrasonography, 56 fetuses be suspected FGR, the other 109 fetuses can not be found abnormal. All the fetuses will be visited pregnancy prognosis until the pregnancy procedure end. The FGR pregnancy would be confirmed by the newborn birth weight<2SD. Compare the hemodynamic parameters between FGR group and. non-FGR group. Estimate the diagnostic and prognostic significance of FGR by UA S/D>2SD or MCAPSV>1.29MOM.Results Use the analysis covariance, between FGR group and non-FGR group, there are significant differences of some UA hemodynamic parameters(EDV,RI,PI and S/D)(P<0.001) and several MCA hemodynamic parameter (PSV)(P<0.01), others hemodynamic parameters have not statistical difference(P>0.05). In the FGR group, 4 fetuses is UA absent diastolic flow(AEDF), of them, 2 fetuses was intrauterine fetal death, 1 fetus was premature. As the pregnancy with UA S/D>2SD or MCA PSV>1.29MOM,there is significant raising in the incidence of a disease (fetal distress in uterusv FGR and neonatal asphyxia) (p<0.05). UA S/D>2SD estimate fetal distress in uterus have a susceptibility of 84.2%, have a specificity of 86.5%. MCA PSV >1.29MOM predict neonatal asphyxia have a susceptibility of 66.7%, have a specificity of 97.6%. Combine UA S/D>2SD or MCA PSV>1.29MOM with the routine antenatal ultrasonography can better diagnose FGR than single routine antenatal ultrasonography, it's specificity is raising(94.2%,98%vs81%) .Conclution UAEDV,PI,RI,S/D and MCA PSV are sensitive indexes for estimate FGR, UA AEDF can prompt the high risk station of fetuses, All suspected FGR fetuses should be examined the fetal UA and MCA flow waveforms by CDFI examination In the late pregnancy, by the way, we can understand fetal hemodynamic changes, judge whether intrauterine fetal hypoxia. Late pregnancy, monitoring UA S/D and MCA PSV can help routine antenatal ultrasonography to evaluate FGR and predict pregnancy prognosis.