超声血流指标联合孕中期血清HCG观察胎盘功能
Ultrasonic Blood Flow Index Combined with Serum β-HCG in Mornitoring the Function of Placenta during Pregnancy
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摘要: 目的 探讨如何预测并有效定量评判胎盘功能.方法 收集研究对象1 157例, 超声测量胎盘血流参数;观察胎盘绒毛血管;记录孕妇血清游离β-HCGMoM值;记录新生儿体长、体重和生命体征综合评分.结果 (1) 血清游离β-HCGMoM值≥2.5宫内发育迟缓发生率显著增加; (2) 宫内发育迟缓胎盘二、三级绒毛动脉管径细小, 二、三级动脉数量明显减少;三级绒毛动脉显示率仅为38%, 其显示率明显低于正常妊娠;胎盘三维能1量多普勒血流指数VI、FI、VFI低于正常妊娠.结论 孕妇血清游离β-HCGMoM值≥2.5时, 存在胎盘功能异常风险, 胎盘绒毛血管及胎盘三维能量多普勒血流指数VI、FI、VFI可定性及定量评价胎盘功能.Abstract: Objective To monitor placental function by using the ultrasonic blood flow index and serumβ-HCG.Me thods From May 2012 to December 2015 in our hospital, 1053 cases of prenatal puerperas were given placenta vascularization index (VI) , blood flow index (FI) and vascularization-blood flow index (VFI) measurement by GE E8 three-dimensional ultrasound at the same time, received β-HCG levels test by using the method of chemiluminescence. Postpartum neonatal body length, body weight and vital signs comprehensive score (Apgar score) were also recorded.Re s ults There were 131 cases with serum freeβ-HCGMo M≥2.5, 123 cases with neonatal weight < 2 500 g, 8 cases with normal weight; 542 cases with 2.0 <β-HCGMo M < 2.5, 4 cases with neonatal weight < 2500 g, 438 cases with normal weight; 425 cases with 1.5 <β-HCG Mo M<2.0, normal weight newborn; 59 cases with β-HCG Mo Mvalues <1.5, normal birth weight. The incidence of intrauterine retardation was 93.8% in puerperas with β-HCGMo M≥2.5, 0.7% in puerperas with 2.0<β-HCGMo M < 2.0, and 0% in puerperas with 1.5<β-HCGMo M < 2.0 and β-HCGMo M < 1.5. The incidence of intrauterine retardation in the group of pregnant women with serum free β-HCGMo M≥2.5 was significantly greater than the control group (P < 0.05) . The placental villi vascular tree of 1053 cases was reconstructed by 3 d power doppler technology, and the primary, secondary and tertiary villi rate of artery in 125 cases in the study group was100%, 73%, 38%, in 6 cases in the study group was 100%, 86% and 73% respectively, and in the control group, the primary, secondary and tertiary villi rate of artery was 100%, 100%, 85%, which were significantly higher than study group (P < 0.05) . Conclus ions When 2.5 > serum free β-HCGMo M of pregnant women > 2.0, the newborn may be associated with intrauterine retardation. Pregnant women serum freeβ-HCGMo M≥2.5, there is obviously increase in the incidence of neonatal intrauterine retardation. For those withintrauterine retardation, the placenta secondary and tertiary villi artery diameter is small, the number of artery decreases significantly. Three-dimensional power doppler blood flow index of VI, FI and VFI are significantly lower than normal. Serum free β-HCGMoM of pregnant women can predict the placenta function, villi vascular artery hierarchical display rate and the three-dimensional power doppler blood flow index can qualitatively and quantitatively determine the placental function. Placenta in mid gestation will be injured because of ischemia and anoxia, and the placental function can be recovered after placental vascular remodeling.
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Key words:
- Ultrasound indicator of blood flow /
- β-HCG /
- Placental insufficiency
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[1] [1]ZUPPA A A, MARAGLIANO G, SCAPILLATI M E, et al.Neonatal outcome of spontaneous and assistedtwin pregnancies[J].Eur J Obstet Gynecol Reprod Biol, 2001, 95 (1) :68. [2]邱日锋, 章春泉.产前超声评价胎儿生长受限的研究进展[J].赣南医学院学报, 2012, 32 (8) :504-506. [3]乐杰主编.妇产科学.第5版.北京:人民卫生出版社, 2000:36. [4]闻良珍, 熊锦文.胎儿宫内发育迟缓的临床研究进展[J].中国实用妇科与产科杂志, 2002, 18 (1) 4-5. [5]吕小利, 薛玉, 许建萍, 等.正常妊娠胎盘绒毛血管树二维和三维超声成像比较[J].江苏大学学报 (医学版) , 2010, 20 (6) 524-526. [6] [6]LEE W, KALACHE K D, CHZIWORAPONGSA T, et al.Three-dimensional power Doppler ultrasonography during pregnancy[J].J Ultrasound Med, 2003, 22 (1) :91-97. [7]张娟, 田永梅.应用三维彩色能量多普勒血管超声成像评价正常妊娠胎盘的血流灌注[J].中华妇幼临床医学杂志 (电子版) , 2010, 6 (4) :259-261. [8] [8]YU C H, CHANG C H, KO H C, et al.Assessment of placental fractional moving blood volume using quantitative three-dimensional power doppler ultrasound[J].Ultrasound Med Biol, 2003, 29 (1) :19-23. [9] [9]EPRETORIUS D H, NELSON T R, BAERGENRN, et al.Imaging of placentalvasculature using three-dimensional ultrasoundand color power Doppler:a preliminary study[J].Ultrasound Obstet Gynecol, 1998, 12 (1) :45-49. [10]刘伯宁, 胎儿宫内发育迟缓的胎盘病理变化中国实用妇科与产科杂志, 2002, 18 (1) :19-20. [11] [11]SENIOR R, BECHER H, MONAGHAN M.Contrast echocardiography:evidence-based recommendations by Eeropean Association of Echocardiography[J].European Journal of Echocardiography, 2009, 10 (2) :194-212. [12]孙亚莉, 吕时铭.孕中期人绒毛膜促性腺激素水平与产科并发症及病例妊娠关系的Meta分析[J].浙江预防医学, 2008, 20 (9) :49-51. [13]姚焕春, 刘国成.孕中期血h CG异常改变在预测方面的研究.国外医学妇幼保健分册, 2001, 12 (2) :54-56. [14] [14] YU C H, CHANG C H, KO H C, et al.Assessment of placental fractional moving blod volume using quantitative threedimensional power Doppler ultrasound[J].Ultrasound Med Biol, 2003, 29 (1) :19-23. [15] [15]MERCE L T, BAU S.Asseddment of paacental vascularization by three-dimensional power Doppler"vascular biopsy"in normal pregnancies[J].Croat Med J, 2005, 46 (5) :765-771. [16] [16]MERCE L T, BARCO M J, BAU S.Reproducibility of the study of pacdental vascularization by three-dimensional power Doppler[J].J Perinat Med, 2004, 32 (3) :228-333. [17]刘艳鸽, 杨秀丽.肝素治疗胎儿宫内生长受限27例临床研究[J].中国现代应用药学, 2006, 23 (7) :176-179. [18]路妍妍, 朱伟杰, 王自能, 等.晚发型胎儿生长受限胎盘组织碱性成纤维细胞生长因子表达及超微结构的观察[J].生殖与避孕, 2009.29 (5) :304-307. [19]路姘妍, 王自能, 金素芳, 等.晚发型胎儿生长受限胎盘组织绒毛微循环变化的体视学分析[J]实用医学杂志, 2010, 26 (17) :3l35-3137. -
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