Influencing Factors Of Fetal Umbilical Flow And The Value Of Predicting Fetal Distress

Objective:Fetal umbilical blood flow may reflect fetal intrauterine condition to some extent.when the umbilical blood flow is abnormal,it suggests that fetal distress may occur.The purpose of this study was to understand fetal umbilical blood flow levels in different pregnancy stages in large samples,to analyze the influencing factors of umbilical blood flow values and to explore the safe boundary values of umbilical blood flow parameters in different gestational weeks to predict fetal distress,and to provide reference for early detection of fetal adverse prognosis,selection of appropriate time to terminate pregnancy or medical intervention.Methods:In this study,a total of 2068 pregnant women who delivered and kept complete data in Xiangtan City First People's Hospital from September 2017 to January 2020 were selected for regular birth examination.Among them,1105 primipara and 963 puerpera were selected.The fetal umbilical cord blood flow images were collected from all pregnant women in the group at different gestational weeks.The SRF608 cord blood flow monitor of GZ Sunray company was used to detect the umbilical cord blood flow images and calculate the end Systolic velocity/end Diastolic velocity?S/D??Resistance index?RI??Pulsation index?PI?.Five groups according to different gestational weeks:weeks group 637 cases,37-39⁺⁶ weeks group 746 cases and?40 weeks group 82 cases.Understanding of fetal umbilical blood flow levels in different pregnancy stages;to compare the umbilical blood flow values of different pregnancy and delivery conditions to find the influencing factors of fetal umbilical blood flow values;to explore the safe boundary value of umbilical blood flow in predicting fetal distress in different gestational weeks by constructing a Receiver operating characteristic?ROC?curve for the diagnosis of fetal distress within different gestational weeks.Results:1.According to this study,the median Umbilical artery?UA?S/D of pregnancy was 2.365,with different stages of pregnancy,2.240 and 2.174.There were marked differences in UA-S/D levels among five groups of pregnant women of different gestational weeks?P<0.05?.2.The UA-RI values in pregnancy were 0.572�0.065,UA-RI levels during different times of gestation were 0.649�0.059,0.600�0.065,0.569�0.056,0.551�0.059 and 0.531�0.055;There were differ statistically in UA-RI levels among five groups of pregnant women of different gestational weeks?P<0.05?.3.The UA-PI in pregnancy were 0.847�0.154,UA-PI levels in different gestational weeks were 1.013�0.164,0.903�0.121,0.836�0.130,0.807�0.16 and 0.768�0.144,There were enormously different in UA-PI changes among five groups of pregnant women of different gestational weeks?P<0.05?.4.The levels of UA-S/D?UA-RI?UA-PI decreased gradually from mid-pregnancy to late pregnancy.Multiple comparisons showed statistically significant differences in UA-S/D?UA-RI?UA-PI between groups?P<0.05?.5.Gestational weeks?fetal distress?and neonatal weight were the common influencing factors of UA-S/D?UA-RI?UA-PI?P<0.05?.The influencing factors of UA-S/D are gravidity and parity?P<0.05?;the influencing factors of UA-PI are parity and hypamnion?P<0.05?.6.The results of the ROC curve of constructing fetal UA-S/D?UA-RI?UA-PI diagnosis of fetal distress in pregnancy<28 weeks showed that the area under the ROC curve was all located between 0.6-0.7?P<0.05?,and the best boundary values were 3.239?0.689?0.979.7.The results of the ROC curve of constructing fetal UA-S/D?showed that the area under the ROC curve was all located between0.5-0.6?P<0.05?,and the best boundary values were 2.947?0.633?1.013.8.The results of the ROC curve of constructing fetal UA-S/D?showed that the area under the ROC curve was all located between0.5-0.6?P<0.05?,and the best boundary values were 2.345?0.603?0.834.9.The results of the ROC curve of constructing fetal UA-S/D?UA-RI?UA-PI diagnosis of fetal distress in pregnancy?40 weeks showed that the area under the ROC curve was all located between 0.7-0.8?P<0.05?,and the best boundary values were 2.151?0.536?0.774.Conclusions:1.Normal fetal umbilical artery hemodynamic index is closely related to gestational weeks,With the continuous development of gestation,showing a downward trend.2.The influencing factors of umbilical blood flow value including gestational week?fetal distress?neonatal weight?gravidity?parity and hypamnion.3.The safety range of fetal umbilical blood flow values is discrepancy in different gestational weeks,therefore,when using umbilical cord blood flow detection in clinical evaluation of fetal intrauterine state,the predictive critical value in this study has a certain reference significance.