Prediction Of Fetal Intrauterine Hypoxia Using Hemodynamic Parameter Of Fetal Renal Artery And Ductus Venosus Combined With Tei Index In Right Ventricle In Gestational Diabetes Mellitus

Diabetes is a common complication during pregnancy and gestational diabetes mellitus,GDM is extremely harmful to the parent body and fetus;fetus is at higher risk of spontaneous abortion,deformity and anoxia,and it may even result in stillbirth.Excessive blood glucose level of GDM patients may also suffer from ketoacidosis,which will decrease the aerobic capacity of placenta,so intrauterine hypoxia may easily occur with increased oxygen consumption of fetus.This study is to combine fetal renal artery,ductus venosus and ventriculus dexter Tei and to assess intrauterine fetal anoxia condition in women with gestational diabetes mellitus,so clinical physicians can be guided for early prevention and achieve good pregnancy result.In this study,79 GDM cases with poor glycemic control?the disease group?and 198 normal pregnant women?the control group?were included.Every pregnant woman was examined in the 28³1⁺⁶week,the 32³5⁺⁶week and the 36³9⁺⁶week.Pulsed wave Doppler?PW?and Tissue Doppler Imaging?TDI?were used to measure and count resistance index of fetus ventriculus dexter Tei index,renal artery?RA?and ductus venosus,pulsatility index?PI?and RA peak systolic flow velocity and end diastolic velocity ratio?S/D?and DV peak systolic flow velocity and atrium peak systolic velocity ratio?S/A?,to compare changes of relevant indexes of two groups in the same gestational age and to analyze changing rules of GDM fetel relevant indexes with gestational age increasing.SPSS17.0 statistical software was adopted for statistical analysis.All measurement data were shown in Mean±Standard deviation????±s?.T test was used for comparison between two groups and variance analysis was used for comparison among multiple groups.P<0.05 was considered to be statistically different.Pearson linear correlation analysis was adopted for correlation analysis.The relevant results based on acquired data were as follows:1.There was no statistical significance in difference of fetus heart rate between two groups?P>0.05?.2.There was no relevance between normal fetus heart rate and ventriculus dexter Tei index?P>0.05?.3.In the week of 28³1⁺⁶,RA,DV relevant indexes and ventriculus dexter Tei index of fetuses from the disease group were all higher than that of the control group,and the difference had statistical significance?P<0.05?.4.In the week of 32³5⁺⁶,RA,DV relevant indexes and ventriculus dexter Tei index of fetuses from the disease group were all higher than that of the control group,and the difference had statistical significance?P<0.05?.5.In the week of 36³9⁺⁶,RA,DV relevant indexes and ventriculus dexter Tei index of fetuses from the disease group were all higher than that of the control group,and the difference had statistical significance?P<0.05?.6.In the disease group,with extension of pregnancy period,RA,DV relevant indexes and ventriculus dexter Tei index of fetuses increased gradually and the difference had statistical significance?P<0.05?.7.RA,DV relevant indexes and ventriculus dexter Tei index of fetuses from the disease group were positively related.In conclusion,ventriculus dexter is dominant in the fetal blood circulation and plays a leading role.Fetal ventriculus dexter Tei index is easy to measure and count and it can better reflect the overall function of ventriculus dexter because it had no evident relevance with fetal heart rate.Fetal RA relevant blood parameters can better evaluate peripheral resistance of placenta,reflect blood supply condition of kidneys from the angle of haemodynamics and further reflects fetal circulation and fetus-placenta circulation condition.Fetal DV,as the indirect index to judge fetus right cardiac function qualitatively or quantificationally,has a good predicating value for prognosis of fetus cardiac abnormality.RA,DV relevant indexes and ventriculus dexter Tei index of fetuses from the disease group are positively related.Intrauterine fetal anoxia in the gestational diabetes mellitus can be predicated by using renal artery,venous conduit blood parameter and ventriculus dexter Tei index and can guide early intervention for clinical physicians,thus providing important information for clinical assessment,treatment and delivery.