孕妇血雌三醇、胎心电子监护及超声脐动脉血流S/D比值检查预测胎儿窘迫的临床价值分析

摘要

Objective To study the diagnosis value of fetal distress of free Estriol,cardiotocography and ultrasound umbilical artery blood flow S/ D ratio in pregnant women. Methods 150 cases of pregnant women with cardiac abnormality were selected from July 2014 to May 2016. According to reference to the diagnosis of fetal distress standards,all were divided into case group (fetal distress,100 cases)and control group (none fetal distress,50 cases),and FE3 level was detected by radioimmunity RIA,and all were given cardiotocography (CTG)and ultrasonic umbilical artery blood S/ D ratio index. Diagnosis value for fetal distress were analyzed. Results The serum FE3,Fischer score levels of case group were significantly lower than those of control group. S/ D ratio incubation,active and second labor period were significantly higher than those of control group. Fischer negative rate was significantly lower than that of control group,and NST reactive proportion was significantly lower than that of control group (P < 0. 05). The diagnosis sensitivity,specificity,positive predictive value,negative predictive value,accuracy,failure di-agnosis and misdiagnosis rate of serum FE3,CTG,S/ D ratio combined indexes or CTG combined S / D ratio were significantly better than serum FE3,CTG,S / D ratio singly detection (P < 0. 05),and the diagnosis sensitivity,negative predictive value and missed diagnosis accuracy of ser-um FE3,CTG,S / D ratio combined indexes or CTG combined S/ D ratio were significantly better serum FE3 combined S / D ratio (P < 0. 05). Conclusion CTG and ultrasound umbilical artery blood S/ D ratio combined detection has significant value in the diagnosis for fetal distress,and it is worthy of clinical popularization and application.%目的 探讨孕妇血雌三醇、胎心电子监护及超声脐动脉血流收缩末期峰值/舒张末期峰值(S/D)比值检查对胎儿窘迫的诊断价值.方法 选取2014年7月至2016年5月期间胎心异常的孕妇150例,参照胎儿窘迫的诊断标准将其分为病例组(胎儿窘迫,100例)与对照组(非胎儿窘迫,50例).采用放射免疫分析仪RIA法测定血雌三醇(FE3)水平,并实施胎心电子监护(CTG)与测定超声脐动脉血流S/D比值,分析上述指标对胎儿窘迫的诊断价值.结果 病例组血清FE3、Fischer评分水平明显低于对照组,潜伏期、活跃期与第二产程S/D比值明显高于对照组,Fischer阴性率明显低于对照组,NST反应型所占比率明显低于对照组(均P<0.05).胎心电子监护联合S/D比值、血清FE3+胎心电子监护+S/D比值诊断灵敏度、特异度、阳性预测值、阴性预测值、准确度、漏诊率与误诊率明显优于血清FE3、胎心电子监护、S/D比值单项检查(均P<0.05);胎心电子监护联合S/D比值、血清FE3+胎心电子监护+S/D比值诊断灵敏度、阴性预测值、准确度与漏诊率明显优于血清FE3联合S/D比值检查(均P<0.05).结论 胎心电子监护与超声脐动脉血流S/D比值联合检查对胎儿窘迫的诊断价值显著,值得临床推广应用.