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The Influence of Common Complications with Pregnancy to the Fetal Blood Flow Velocity Waveforms and the Value

Author: LiLiLi
Tutor: ShiHong
School: Dalian Medical University
Course: Obstetrics and Gynaecology
Keywords: Preeclampsia GDM UA MCA Ultrasonography
CLC: R714.25
Type: Master's thesis
Year: 2011
Downloads: 1
Quote: 0
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Abstract


Objective: To discuss the influence of common complications with pregnancy to the fetal umbilical artery(UA) and middle cerebral artery(MCA),and the value of Abnormal values of UA and MCA to predicting fetal prognosis.Methods:Color Doppler was used to examine the blood flow velocity waveforms of umbilical artery(UA) and middle cerebral artery (MCA) in normal pregnancy 60cases,pregnancy of preeclampsia 50 cases, with fetal growth restriction and fetal distress and neonatal asphyxia 10cases,diabetesmellitus (CDM) 39cases, the peak- systolic/diastolic ration(S/D),resistance index (RI) values of UA and MCA were calculated .Results:①The values of UA in the Normal pregnancies group decrease with gestational age increased,Pregnancy 28-42 weeks,the comparison between the difference weeks was statistically insignificant ( P﹥0.05 );②Patients of the preeclampsia with fetal growth restriction and fetal distress and the neonatal asphyxia were higher than the normal group, have obviously difference (P﹤0.05);③The values of UA in patients of preeclampsia without above complications and the GDM have no obviously difference from the normal group(P﹥0.05);④The values of MCA have no obviously difference among the three groups(P﹥0.05);⑤When the S/D of UA is unnomal, the fetus was at risk of hypoxia ,the distress and the incidence of FGR, about64.7 percent(P﹤0.05)..Conclusion: 1.The values of UA in the patients of preeclampsia with fetal growth restriction and fetal distress and neonatal asphyxia were higher than the normal group,in patients of other preeclampsiaand the GDM have no obviously difference from the normal group,the values of MCA have no obviously difference. That examination of fetal blood flow velocity waveforms in UA of the preeclampsia patients is a valuable method of fetal monitoring and useful in predicting fetal prognosis.2. According to this study, the sensitivity and specific degrees of S/D and RI of UA for forecast FGR, fetal distress and the incidence of neonatal asphyxia are respectively 78.57% and 95.56%,MCA indexs sensitivity and specificity are 23.5% and 83.6% respectively. This study does not very well reflect the sensitivity of the MCA, there may be clinically superiority of lack of oxygen for mild insufficient to results deviation of diagnosis, we can use more sensitive index for instance acidosis or blood gas analysis as research index further research.3 This study of fetal gestational diabetes patients umbilical arterial and cerebral artery flow index were not significantly change, maybe because of the cases without of vascular lesions in this study, placenta has no obvious function affected, but whether gestational diabetes patients with bad fetal prognosis are related to other index ,for example lung maturity, so clinically should combine other indicators comprehensive for judgments pregnancy outcomes.

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CLC: > Medicine, health > Obstetrics and Gynaecology > Obstetrics > Pathological pregnancy ( abnormal pregnancy ) > Complications of pregnancy
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