摘要
目的:探讨剪切波弹性成像(SWE)检测妊娠期糖尿病(GDM)晚孕期胎盘弹性,用于预测分娩期并发症及分娩结局的价值。方法:选取医院就诊的235例晚孕期孕妇,按照有无GDM将其分为GDM组(82例)和健康对照组(153例)。两组均采用常规超声测量孕妇胎儿脐动脉血流参数胎儿脐动脉收缩压与舒张压的比值(S/D)、血管阻力指数(RI),采用SWE测量前壁胎盘中心及其边缘的弹性值,比较两组临床资料、常规超声和SWE值的差异;采用Spearman相关分析SWE值与分娩期并发症和分娩结局的相关性。结果:GDM组胎盘中心及边缘平均SWE值显著高于健康对照组,差异有统计学意义(t=13.553,t=13.264;P<0.05),但组内胎盘中心与边缘SWE值比较差异无统计学意义。GDM组产后出血、子痫前期、胎膜早破、胎盘早剥以及酮症酸中毒的发生率显著高于健康对照组,差异有统计学意义(x^(2)=9.345,x^(2)=11.438,x^(2)=9.785,x^(2)=0.736,x^(2)=7.525;P<0.05),并与SWE值呈正相关关系(r=0.687,r=0.920,r=0.902,r=0.736,r=0.785;P<0.05)。结论:GDM孕妇胎盘中心及边缘SWE值较正常妊娠孕妇显著增加,并随着GDM加重而增加。SWE可作为评估GDM孕妇胎盘功能并预测分娩期并发症和分娩结局的有效手段。
Objective:To explore the value of shear wave elastography(SWE)in predicting complications of delivery period and delivery outcomes by detecting placenta elasticity within later pregnant period of patients with gestational diabetes mellitus(GDM).Methods:The 235 pregnant women who were within later pregnant period and admitted to hospital were selected and were divided into GDM group(82 cases)and health control group(153 cases).Both two groups adopted routine ultrasound to measure the blood flow parameters,the ratio of systolic pressure/diastolic pressure(S/D)and vascular resistance index(RI)of umbilical artery of fetus,and adopted SWE to measure the elasticity value of central and peripheral placenta anterior.The differences of clinical data,routine ultrasound and SWE value between two groups were compared.And the correlation between SWE and the complications of delivery period and delivery outcomes were analyzed by using Spearman correlation analysis.Results:The average SWE values of central and peripheral placenta of GDM group were significantly higher than those of healthy control group(t=13.553,t=13.264,P<0.05).However,the SWE value within each group between central and peripheral placenta was insignificantly different.The incidence rates of postpartum hemorrhage,preeclampsia,premature rupture of fetal membrane,abruption placenta and ketoacidosis of GDM group were significantly higher than those of health control group(x^(2)=9.345,x^(2)=11.438,x^(2)=9.785,x^(2)=0.736,x^(2)=7.525,P<0.05),and they were positive correlation with the SWE value(r=0.687,r=0.920,r=0.902,r=0.736,r=0.785,P<0.05).Conclusions:The SWE value of central and peripheral placenta of GDM pregnant women were significantly higher than that of healthy pregnant women,and the SWE value increases with the aggravating of GDM.SWE can be used as an effective mean method in assessing the placenta functions of GDM pregnant women and predicting complications of delivery period and delivery outcomes of them.
作者
刘耘利
伍丹
郭志伟
杨伟清
成方霞
谢梅兰
刘彦红
LIU Yunli;WU Dan;GUO Zhi-wei(Ultrasonography Department,Zhuhai Center for Maternal and Child Health Hospital,Zhuhai 519000,China;不详)
出处
《中国医学装备》
2021年第7期103-107,共5页
China Medical Equipment
基金
广东省医学科学技术研究基金(B2016113)“单绒毛膜性双胎输血综合征早孕期超声指征研究”。
