【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.更多还原

【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.更多还原