First Trimester Ductus Venosus Blood Flow Spectrum Parameter In Ultrasound And The Correlation Between Its Abnormal Spectrum And Different Pregnancy Outcomes

Objective:Collect ductus vensous spectrum of fetuses from 11 to 13⁺66 weeks and analyze the normal reference value range of ductus venosus blood flow parameters in early pregnancy.Combine the direction of a wave of ductus venosus and explore the correlation between abnormal ductus venous blood flow spectrum and different pregnancy outcomes.Methods:From November 2018 to December 2019,530 fetuses from 11 weeks to 13⁺⁶weeks were selected as the research subjects,and all the fetuses were followed up.Among them,the fetus with normal ductus venosus a wave morphology and normal pregnancy outcome was the control group,and the fetus with abnormal ductus venosus a wave morphology（disappeared or reversed）was the test group.All fetuses were followed up to check whether there were cardiac malformations,chromosomal abnormalities or other malformations,to measure the value of ductus venosus blood flow spectrum in normal fetuses during early pregnancy and to explore the correlation between abnormal ductus venosus blood flow spectrum and different pregnancy outcomes.Selection criteria:（1）Pregnant women aged 20-35 years old,no obstetric complications.（2）For a single child,the last menstrual period is clear and the menstrual period is regular.（3）The quality of the two-dimensional image of the fetus is good.When the fetus is quiet,the enlarged image only shows the fetal chest and abdomen,and the ductus venosus blood flow is clearly displayed.（4）The ultrasound of the control group confirmed that the biparietal diameter and crown-lump length were consistent with the menopause period.Results:A total of 499 fetuses in 530 fetuses had normal morphology of ductus venosus from 11 to 13⁺66 weeks.After follow-up,484 fetuses with normal prenatal ultrasound and postnatal outcomes was the control group,the normal reference value range of blood flow spectrum parameters of 11 to 13⁺⁶weeks’fetus is:S:40.64±7.02;D:32.15±7.43;a:10.67±3.30;M:30.02±5.53;PI:1.00±0.15;PLI:0.73±0.07;PVIV:0.96±0.26;a/S:0.27±0.07;a/D:0.36±0.12;RI:0.21±0.12;the other 15patients had abnormal pregnancy outcomes,compared with the former,S,D,a,M,a/S,a/D and RI decreased,and PI and PLI increased.Through statistical analysis,the changes of a,a/S,a/D,PI and PLI were statistically significant（P<0.05）.In the test group,31 cases of fetal ductus venosus spectrum showed a wave morphological abnormality（disappeared or reversed）.The incidence of fetal cardiac malformation in this group was 9.68%（3/31）,the incidence of chromosomal abnormalities was 12.90%（4/31）and the incidence of other deformities was 6.45%（2/31）,which were significantly higher than those in the normal group of a wave shape:1.00%（5/499）,0.80%（4/499）,1.20%（6/499）.The sensitivity of a wave morphological abnormality to the diagnosis of abnormal pregnancy outcome was 60.53%（23/38）,and the specificity was 98.37%（484/492）,among them,the sensitivity for detecting cardiac abnormalities is 37.50%（3/8）,and the sensitivity for detecting chromosomal abnormalities is 50.00%（4/8）.Conclusion:The normal reference value range of ductus venosus blood flow spectrum parameters of normal fetuses from 11 to 13⁺⁶weeks is:S:40.64±7.02;D:32.15±7.43;a:10.67±3.30;M:30.02±5.53;PI:1.00±0.15;PLI:0.73±0.07;PVIV:0.96±0.26;a/S:0.27±0.07;a/D:0.36±0.12;RI:0.21±0.12;compared with the above measurement,when a wave does not disappear or reverse,the decrease of the speed of a wave,a/S,a/D and the increase in PI and PLI can have a suggestive role on the abnormality of the fetus.The incidence of fetal heart malformation,chromosomal abnormalities and other abnormalities in a wave morphology abnormal group were significantly higher than those in the normal group of a wave morphology normal group.The abnormality of a wave morphology of ductus venosus was helpful to predict the abnormal pregnancy outcome.