column:Detection of fetal umbilical artery and middle cerebral artery blood flow by ultrasound for prediction of pregnancy outcome among births affected by velamentous umbilical cord insertion / 中国基层医药

ABSTRACT

Objective:To investigate the clinical value of detection of fetal umbilical artery and middle cerebral artery blood flow by ultrasound in predicting the pregnancy outcome among births affected by velamentous umbilical cord insertion.Methods:Ninety pregnant women who undergo regular prenatal examination and delivered births with velamentous insertion of the umbilical cord from April 2017 to April 2020 in Quzhou Maternal and Child Health Hospital were included in this study. All patients were examined by transabdominal color Doppler ultrasound in the second trimester of pregnancy. The resistance index (RI) and systolic/diastolic flow velocity ratio (S/D) of fetal umbilical cord and middle cerebral artery were recorded and compared between pregnancy outcomes. The RI and S/D of umbilical cord and middle cerebral artery of births affected by velamentous umbilical cord insertion were correlated with adverse pregnancy outcome.Results:The RI and S/D of umbilical cord in births affected by adverse pregnancy outcome were higher than those in births not affected by adverse pregnancy outcome [ RI (0.72 ± 0.08) vs. (0.63 ± 0.05); S/D (3.08 ± 0.46) vs. (2.59 ± 0.35)]. The RI and S/D of middle cerebral artery in births affected by adverse pregnancy outcome were lower than those in births not affected by adverse pregnancy outcome [RI (0.55 ± 0.06) vs. (0.79 ± 0.09); SD (3.41 ± 0.37) vs. (5.26 ± 0.61)]. The differences were statistically significant ( t = 8.327-15.429, P = 0.000-0.000 < 0.05). RI and S/D of umbilical cord in births affected by velamentous insertion of the umbilical cord were positively correlated with adverse pregnancy outcome ( r = 0.779, 0.883, P = 0.004, < 0.05). RI and S/D of middle cerebral artery in births affected by velamentous umbilical cord insertion were negatively correlated with adverse pregnancy outcome ( r = -0.752, -0.847, P = 0.007, < 0.05). Conclusion:Detection of RI and S/D of umbilical cord and middle cerebral artery by color Doppler ultrasound in the second trimester of pregnancy is of certain clinical value in predicting the pregnancy outcome among births affected by velamentous umbilical cord insertion. This should be paid more attention in department of obstetrics and gynecology.