国际生殖健康/计划生育 ›› 2014, Vol. 33 ›› Issue (5): 401-404.

• 综述 • 上一篇    

脐动脉血流与围生期结局的研究进展

陈艳敏,陈丹青   

  1. 310006 杭州,浙江大学医学院附属妇产科医院产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-09-15 发布日期:2014-09-15
  • 通讯作者: 陈丹青

Umbilical Artery Blood Flow and Perinatal Outcomes

CHEN Yan-min,CHEN Dan-qing   

  1. Department of Gynecology,Women′s Hospital,School of Medicine,Zhejiang University,Hangzhou 310006,China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-09-15 Online:2014-09-15
  • Contact: CHEN Dan-qing

摘要: 脐动脉血流监测是一种无创、简单、快捷的方法,临床上用于评估胎儿宫内健康情况,预测围生儿的预后。在高危妊娠中,可以较灵敏地检测胎儿缺氧。脐动脉血流异常的常见原因包括胎盘功能不全、脐带异常、胎儿畸形、妊娠期高血压疾病和胎儿生长受限(FGR)等。脐动脉血流缺失/逆流提示围生儿预后不良,并发症包括脑室内出血、脑室周围白质软化、神经系统发育异常、支气管肺发育不全、呼吸窘迫综合征、坏死性肠炎、血小板减少症等,甚至围生期死亡。脐动脉血流的监测价值主要针对妊娠并发FGR和(或)子痫前期人群。目前研究结果主张FGR合并脐动脉血流缺失的胎儿在妊娠34周后,即使胎心或生物物理评估正常也应考虑终止妊娠;如果孕周小于34周,应积极采用促胎肺成熟后终止妊娠。

关键词: 脐动脉, 胎儿生长迟缓, 妊娠结局

Abstract: The monitoring of umbilical artery blood flow,a noninvasive,simple and convenient method,is widely used in clinic in order to evaluate fetal health and predict the perinatal outcomes. It is a sensitive method to monitor fetal distress in those high-risk pregnancies. The common causes of abnormal umbilical artery blood flow include placental dysfunction,abnormal umbilical cord,fetal abnormalities,gestational hypertension disease,fetal growth retardation(FGR) and so on. Abnormal umbilical artery flow,such as absent flow and the reversed end-diastolic velocity during pregnancy,is associated with intraventricular hemolysis,periventricular leukomalacia, neurodevelopmental impairment,bronchopulmonary dysplasia, respiratory distress syndrome,necrotic enteritis,thrombocytopenia,and even perinatal mortality. Pregnant women with complications,such as preeclampsia and FGR,should be advised to evaluate the umbilical artery doppler velocimetry. It was suggested that delivery should be considered in those pregnant women whose FGR and absent end-diastolic umbilical artery flow were found at >34 weeks,and that fetal lung maturity should be antenatally induced by corticosteroids for premature delivery if absent or reversed end-diastolic flow was found at <34 weeks.

Key words: Umbilical arteries, Fetal growth retardation, Pregnancy outcome