| Objective:By using color Doppler ultrasound instrument to detect the blood flow parameters and its corresponding ratio of late pregnancy fetal umbilical artery(UA),fetal middle cerebral artery(MCA)and renal artery(RA),to analyze the clinical value of the above indexes in fetal distress.Materials and methods:200 women whose age were 21 to 38 and gestational age were 36 to 42 weeks for hospital inspection from September 2016 to March 2017 were included,and they were all hospital childbirths with all singletons,routine ultrasound examined.100 cases of high-risk pregnancy pregnant women and 100 cases of late pregnancy normal pregnant women as high-risk group and control group.Using color Doppler flow imaging(CDFI)to show fetal umbilical artery、fetal middle cerebral artery and renal artery.Then,the blood flow parameters of each artery were measured by spectral Doppler.The peak systolic velocity(S)and end-diastolic velocity(D)ratio(S/D),Pulsation index(PI),Resistant index(RI)and the PI ratio of MCA to UA and MCA to RA were calculated.All the fetuses would be visited pregnancy prognosis until the pregnancy procedure end.Statistical methods were used to compare the reliability,clinical value and prognosis evaluation of fetal distress.Results:1.At the pregnancy 36 to 42 weeks,The resistance indexes(PI、RI、S/D)of fetal umbilical artery in the high-risk group were higher than those in the control group.There is a statistical significance(p<0.001).2.The resistance indexes of middle cerebral artery in the high–risk group were lower than those in the control group.There is a statistical significance(p<0.001).3.The resistance indexes of renal artery in the high–risk group were higher than those in the control group.There is a statistical significance(p<0.001).4.PI ratio of MCA to UA and MCA to RA in the high–risk group were lower than those in the control group with significant difference(p<0.001).5.The proportion of fetal distress in the high-risk group was higher than that in the control group with significant difference(p<0.01).Late pregnancy high-risk pregnancy perinatal outcomes were significantly higher than normal late pregnancy fetal incidence of abnormal with significant difference(p<0.01).6.With single index UA-PI>1.45,UA-RI>0.63,UA-S/D>2.77 in the diagnoses of fetal distress at late pregnancy 36 to 42 weeks,the sensitivity and specificity were 69% and 81%,85% and 83%,81% and 85%,the Youden index respectively were 50%,68% and 66%.With single index MCA-PI<1.51,MCA-RI<0.65,MCA-S/D<3.82 in the diagnoses of fetal distress at late pregnancy 36 to 42 weeks,the sensitivity and specificity were 85% and 81%,82% and 83%,82% and 85%,the Youden index respectively were 66%,65% and 67%.With single index RA-PI>1.97,RA-RI>0.80,RA-S/D>5.08 in the diagnoses of fetal distress at late pregnancy 36 to 42 weeks,the sensitivity and specificity were 67% and 74%,67% and 67%,70% and 69%,the Youden index respectively were 41%,34%,39%.With indexes MCA-PI/UA-PI<1.14 and MCA-PI/RA-PI<0.81 in the diagnoses of fetal distress at late pregnancy 36 to 42 weeks,the sensitivity and specificity were 80% and 92%,82% and 88%,the Youden index respectively were 72% and 70%.7.Multi-parameter joint analysis of fetal distress,sensitivity,specificity was 98%,95%.The Youden index was the largest,93%.Plot the receiver operating characteristic carve with the above parameters,the result showed that the maximum area under the ROC examined by combined detection indexes.Conclusion:1.The blood flow parameters of umbilical artery,middle cerebral artery and renal artery are important indexes on the diagnostic value of fetal distress.2.MCA-PI/UA-PI,MCA-PI/RA-PI can be more sensitive and accurate determination of fetal hypoxia,can accurately predict the state of the fetus in utero.3.The above parameters can further improve the accuracy of diagnosis to provide objective basis for clinical application,and to guide the clinical treatment and prognosis. |
