胎儿脐动脉血流速度与新生儿结局的关系

目的；探讨胎儿脐动脉血流速度与新生儿结局的关系。方法：对１６６名孕妇的脐动脉收缩期峰值（Ｓ）与舒张末期峰值（Ｄ）比值（Ｓ／Ｄ比值）测定结果、新生儿结局进行回顾性分析。结果：Ｓ／Ｄ比值异常者１７例，其中小于胎龄儿１２例（７０％），新生儿死亡３例（１８％）；正常１４９名中小于胎龄儿７例（５％），无新生儿死亡，两组比较有显著性差异。结论：胎儿脐动脉Ｓ／Ｄ比值可作为评估新生儿结局的一个重要指标。     

脐动脉及子宫动脉血流速度波形检查在产科的应用

脐动脉及子宫动脉血流速度波形检查在产科的应用解放军军医进修学院创伤中心３０４医院张琳综述张素梅审校胎盘功能监测是产科临床中的重要内容之一，是产科医生进行临床决策的重要参考内容，它关系到产科质量的优劣和围产儿的预后。而胎盘功能与子宫。胎盘、胎儿－胎盘的...     

妊娠妇女被动吸烟对脐动脉血流速度及血气的影响

目的：研究孕妇被动吸烟对脐动脉血流速度及脐动脉血气分析的影响。方法：通过测定48例被动吸烟孕妇的脐动脉血流速度、脐动脉血气分析以及新生儿体重,同时与44例正常孕妇进行比较。结果：被动吸烟组孕妇的脐动脉血流速度明显升高,脐动脉中氧分压明显下降,而二氧化碳分压明显升高。结论：烟雾中尼古丁和一氧化碳使孕妇血管收缩,影响了胎盘、胎儿的供血供氧,从而导致新生儿体重下降。     

超声检测妊娠晚期脐动脉血流速度（S／D）1908例临床分析

【目的】了解妊娠晚期脐动脉血流收缩期峰值流速与舒张末期流速比值（S／D）的异常发生率。【方法】妊娠28周以上单胎孕妇1908例,应用MFM—OBS型产科综合诊断监护系统（脐血流）进行脐动脉血流速度测定,并计算出S／D、PI、RI、FVR及胎心率,分析不同妊娠周数异常S／D值的发生率。【结果】随着妊娠周数的增加,S／D均值由孕28周时的2．98下降至孕40周时的2．22,平均每周下降0．063;各孕周S／D异常值发生率平均为5．5％。【结论】妊娠晚期监测脐动脉血流速度的变化,有利于判断及随访胎儿宫内缺氧状态,能为正确的产科处理提高依据。     

胎儿脐动脉及大脑中动脉血流监测对胎儿预后的作用

目的 评价超声监测胎儿脐动脉及大脑中动脉血流对胎儿预后的作用。方法 应用彩色多普勒监测６９例中晚期正常妊娠及１６例宫内缺氧（窘迫）组及５例围产儿死亡组胎儿大脑中翅膀（ＭＡＣ）、脐动脉（ＵＡ）收缩期最大血流速度（Ｓ）与舒张末期血流速度（Ｄ）的比值（Ｓ／Ｄ）及阻力指数（ＲＩ）并与妊娠结局相对照。结果 正常妊娠时随孕周增加ＵＡ、ＭＣＡ的Ｓ／Ｄ及ＲＩ值逐渐下降;异常组ＵＡ的Ｓ／Ｄ、ＲＩ值均明显高于正常组,     

妊高征时胎儿血流速度波形改变的特点

本文共收集了妊高征９６例，正常妊娠１４８例。于产前１ｗｋ内行彩色多普勒超声检测胎儿ＵＡ、ＲＡ和ＭＣＡ的ＰＩ。产后随访围产儿预后。２４４例孕妇中，胎儿窘迫２９例，发病率为１１．９％。正常妊娠、轻度、中度和重度妊高征中，胎儿窘迫的发病率分别为７．７％、９．１％、１６．２％和３０％。按围产儿预后分成良好和不良两组，在两组中，随着妊高征的加重，胎儿ＵＡ、ＲＡ和ＭＣＡ的ＰＩ均有上升的趋势。按正常妊娠、轻度、     

脐动脉舒张期血流缺失(AEDF)1例

孕妇，27岁，住院号10650，因停经31^2 周，发现脐动脉血流值异常4^-周于2003年7月14日入院。孕妇既往月经规律，反复核实孕周无误，妊娠早期无特殊不适，孕24周常规行产前检查时发现脐血流异常，偶见脐动脉舒张未期血流缺失，未发现明确的胎儿发育衣羊水量异常，后反复多次复查脐动脉血流，均提示S/D值增加，偶有AEDF，严密观察8周未现胎儿生长速度异常，故未予以治疗。     

胎儿脐动脉舒张末期血流缺失与妊娠结局的相关性研究

【目的】探讨胎儿脐动脉舒张末期血流缺失（AEDV）与妊娠结局的关系。【方法】产前常规应用脉冲多普勒技术行胎儿脐动脉血流频谱检测,确诊为AEDV孕妇36例,分析AEDV与妊娠合并症、妊娠结局的关系。【结果]36例AEDV病例中,重度子痫前期69．4％（25／36）,胎儿生长受限80．6％（29／36）,羊水过少22．2％（8／36）,妊娠期肝内胆管淤积症11．1％（4／36）,妊娠期糖尿病8．3％（3／36）;胎儿先天畸形发生率为16．7％（6／36）,病死率55．6％（20／36）。【结论】脐动脉舒张末期血流缺失是脐动脉血流阻力增高的特有袁现,表明胎儿一胎盘循环障碍,妊娠合并症增多,胎儿预后不良,临床应给予高度重视。     

56例妊娠期糖尿病胎儿脐动脉、大脑中动脉血流彩色多普勒超声检查分析

<正>妊娠合并糖尿病为高危妊娠,近年发病率有逐渐增高的趋势,妊娠糖尿病孕妇在产妇中的发病率接近7%[1]。高血糖与妊娠糖尿病孕妇的不良反应密切相关,如未得到合理治疗,可严重危害母婴健康。本文应用彩色多普勒超声仪检测妊娠期糖尿病孕妇胎儿UA和MCA血流等指标,并与正常组比较,探讨其预测胎儿宫内缺氧的应用价值。     

胎儿不同段脐动脉与大脑中动脉血流动力学的关系研究

目的：探讨不同段脐动脉（UA）与胎儿大脑中动脉（MCA）血流动力学之间的关系。方法选择2012年至2013年南京明基医院常规检查的中晚期孕妇265例为研究对象,检查分析265例中晚孕胎儿不同段UA（胎盘附着部、漂浮部、脐轮部）与胎儿MCA的血流动力学参数,如搏动指数（PI）、阻力指数（RI）、峰值流速与舒张末期流速比值（S/D）,研究两者间的关系。结果MCA的PI、RI、S/D大于UA脐轮部（P＜0．01）。UA脐轮部的PI、RI、S/D大于UA漂浮部（P＜0．01）。UA漂浮部的PI、RI、S/D大于UA胎盘附着部（P＜0．01）。结论通过对UA不同段的血流动力学监测,最终确定脐轮部检测效果较佳,能准确反映胎儿血氧状态,值得临床借鉴使用。     

高压氧治疗对胎儿宫内发育迟缓脑及脐动脉血流速率的影响

目的观察高压氧对胎儿宫内发育迟缓（ＩＵＧＲ）胎儿脑及脐动脉血流速率的影响。方法将４３例伴有多普勒血流异常的ＩＵＧＲ患者分为两组：高压氧组２４例,采用高压氧治疗;氨基酸组１９例,采用氨基酸治疗。测定治疗前后胎儿大脑中动脉（ＭＣＡ）、脐动脉（ＵＡ）血流速率以及ＲＩｍｃａ和ＲＩｕａ的变化,观察妊娠足月时该指标恢复情况以及与新生儿预后的关系。结果高压氧组胎儿ＲＩｍｃａ明显上升,ＲＩｕａ明显下降;足月时,ＲＩｍｃａ、ＲＩｕａ正常转变率７０．８％,与氨基酸组比较．差异有显著性（Ｐ＜０．０５）;持续异常组新生儿低Ａｐｇａｒ评分、小于孕龄儿发生率分别为６０％和８０％,明显高于正常组（Ｐ＜０．０５和Ｐ＜０．０１）。结论高压氧治疗能有效地改善ＩＵＧＲ胎儿异常的脑及脐动脉血流速率,纠正胎儿宫内缺氧,减少低体重儿的发生。     

Doppler blood velocity waveforms in the umbilical artery as an indicator of fetal well-being

Doppler blood velocity waveforms were analyzed from the umbilical artery as an indication of fetal well-being. Since the ratio of systolic to diastolic peak flows (A/B) reflects placental vascular resistance, an abnormality of this value may accurately predict compromised fetuses. Twenty-one studies were performed on 13 patients, using a new duplex system for real-time imaging and range-gated pulsed Doppler analysis, and compared to normal standards. Thirteen studies done in nine uneventful pregnancies were consistently normal. However, abnormal studies were found in the four patients reported as case histories, including women with sickle cell anemia, systemic lupus, diabetes, and growth retardation. The A/B ratio was felt to have predicted potential fetal compromise, including the two fetal deaths. Therefore, with certain cautions, we feel that this rapid, non-invasive technique is useful as a serially applicable reflector of the status of fetoplacental circulation.     

Doppler methods for quantitative measurement and localization of peripheral arterial occlusive disease by analysis of the blood flow velocity waveform

Errors concerned with the use of continuous wave Doppler ultrasound for the quantitative assessment of peripheral arterial occlusive disease by analysis of the blood flow velocity waveform are briefly examined. It is shown that, while some of the simpler signal processing techniques are inadequate, techniques such as real-time frequency analysis of the Doppler signal can yield information of quantitative value. A new multifilter system is described that yields the instantaneous maximum velocity waveform. From the results of preliminary patient studies using this system, it is concluded that clinically significant peripheral arterial disease can be quantified and regionally localized.     

Recording of blood flow velocity waveforms in the uteroplacental and umbilical circulation: reproducibility study and comparison of pulsed and continuous wave Doppler ultrasonography

Reproducibility of the blood flow velocity waveforms (FVW) recorded from the umbilical artery and the arcuate arteries on the right and left side of the placenta was examined in 8 women with normal pregnancies and anterior placentas. The FVW were recorded using a 2-MHz pulsed Doppler ultrasound system in combination with a real-time linear-array scanner. The FVW were characterized by the pulsatility index (PI) and systolic/diastolic (S/D) ratio. For the PI, the mean coefficients of variation between six operator pairs in the umbilical artery and the left and right arcuate arteries were 8.4%, 26%, and 21.5%, respectively. These findings suggest that, in clinical practice, the umbilical artery FVW is reproducible, but the usefulness of arcuate artery FVW is limited by the wide variation of Doppler signals. Paired recordings of FVW were obtained from the umbilical, arcuate, and uterine arteries using pulsed wave and continuous wave Doppler ultrasonography in a randomized order in another 21 pregnant women with anterior placentas. There was no difference between the two Doppler modes for any of the measured waveform indices.     

胎儿三尖瓣反流与脐动脉及大脑中动脉超声血流频谱的相关性分析

目的观察胎儿三尖瓣反流时脐动脉和大脑中动脉（MCA）血流频谱的变化,探讨不同程度胎儿三尖瓣反流对脐动脉和MCA血流频谱的影响。方法测量三尖瓣反流时胎儿脐动脉和MCA的血流频谱,分析胎儿不同程度三尖瓣反流时脐动脉和MCA频谱的变化情况,并与对照组比较分析。结果三尖瓣I、Ⅱ级反流时,胎儿脐动脉和MCA血流频谱与对照组比较差异无统计学意义。三尖瓣Ⅲ、Ⅳ级反流时,脐动脉阻力指数、搏动指数及收缩期峰值血流速度与舒张期血流速度比值（s／D）均增高,MCA阻力指数、搏动指数及s／D均降低,与对照组比较差异有统计学意义（P〈0．05）。结论三尖瓣I、Ⅱ级反流对胎盘功能影响不大,宫内缺氧不明显;中重度三尖瓣关闭不全则会影响胎盘功能,进而引起胎儿官内缺氧,产生脑保护效应。     

Acceleration time in normal fetal umbilical artery at term and its relationship to the cord blood hematocrit

The purpose of this study was to test the hypothesis that the acceleration time (AT) of the fetal umbilical artery remains constant at term for normal pregnancies. In addition, we also examined whether the AT has any correlation with umbilical cord blood hematocrit (Hct). In total, 539 normal-term fetuses with menstrual ages (MA) ranging from 37 weeks to 42 weeks were enrolled in a cross-sectional design. The AT of the fetal umbilical artery was measured prior to delivery using a high-resolution, real-time Doppler scanner. All were delivered within 2 days of the ultrasound examination. At parturition, blood from the umbilical vein was collected and the red cell indices, including the Hct, were determined. The results indicated that the mean values of AT of the umbilical artery remained constant during normal-term pregnancies from 37 weeks to 42 weeks, menstrual age (mean: 0.104 sec, SE: 0.001 sec, n = 539). Although the AT was thought to be affected by the Hct, the AT had no correlation with umbilical venous Hct (n = 539, r = 0.002, p > 0.05). This constant value of the AT may be used as a reference for fetal physiology and perinatal medicine. © 1995 John Wiley & Sons, Inc.     

Doppler ultrasound waveforms in the fetal umbilical artery: quantitative analysis technique

Doppler ultrasound waveforms from the fetal umbilical artery were analyzed by a new quantitative technique. Normal pregnancy and cases of fetal growth failure were considered. Data from the spectrum analyzer were dumped to a microcomputer, the velocity waveforms calculated and a representative waveform obtained by ensemble averaging. This curve was then fitted by a 4-parameter analytic function. We introduce R, the relative flow rate index, which measures the ratio of the average flow rate before the systolic peak to the average rate during the remainder of the cardiac cycle. In cases of fetal growth failure this ratio was significantly greater than in normal pregnancy. Other new quantities defined are the normalized systolic decay time index and the constant flow ratio. The AB ratio was also calculated. Fetal growth failure has been associated with raised placental resistance. We suggest that the fetus can initially compensate for this by increasing cardiac contractility. This can be seen by interpreting the R and AB values together. Our analysis technique enables the waveform to be efficiently described, and provides useful diagnostic information about placental function and fetal wellbeing.     

Flow velocity analysis of umbilical and uterine artery flow in pre-eclampsia treated with propranolol or pindolol.

In a double blind study, 20 gravidas with pre-eclampsia were randomly allocated to treatment with either propranolol 120 mg/day or pindolol 15 mg/day for 7 days. Flow velocimetry was performed before and after treatment to assess the influence of these two regimens of beta blocker on the feto-placental circulation. A continuous wave Doppler unit was used to measure umbilical and uterine artery flow velocity waveforms. The systolic/diastolic (A/B) ratio and the systolic minus diastolic divided by systolic (A-B)/A ratio (resistance index) were used as indexes of blood flow resistance in the umbilical and uterine arteries, respectively. A resistance to flow in the uteroplacental circulation was significantly less in patients treated with pindolol compared to those treated with propranolol (P less than 0.01). The same pattern was also found in umbilical velocimetry, although the statistical significance was borderline (P = 0.06). Although both drugs were equally effective in reducing blood pressure at rest, their effect on the peripheral resistance was different. Pindolol appears to act in part through a peripheral vascular mechanism. Our data support this assumption because the flow in the uteroplacental bed, as reflected by a decrease in resistance index, improved when patients were treated with the drug pindolol.     

Real-time identification of blood flow in the placenta and umbilical cord

Blood flow in the umbilical cord and placenta has been observed with real-time sonography. In some of the larger “cystic” spaces within the placenta a pattern of pulsatile, whorling, and accelerating flow is seen, suggesting an arteriovenous connection.     

Renal blood flow velocity in neonates with and without umbilical artery catheters

We performed an observational prospective cohort study on the applicability of two-dimensional echocardiography with pulsed Doppler technique as a noninvasive modality to serially evaluate renal blood velocities in premature neonates with and without umbilical artery catheters. We also sought to determine the incidence of umbilical artery catheter-related thrombus formation in our neonatal intensive-care unit. We established normative values for renal artery blood flow velocities in premature neonates and postulate that this echo-Doppler technique is valid and can be used to evaluate renal developmental physiology in the neonatal population. In addition, we observed that even in the absence of clinical sequelae due to thrombus formation, the presence of a thrombus in the aorta caused abnormalities in renal hemody-namics. © 1994 John Wiley & Sons, Inc.