Objective To explore the hemodynamic changes of umbilical artery,middle cerebral artery and venous duct in fetal growth restriction(FGR),and to construct a prediction model for poor pregnancy outcomes of FGR.Methods The clinical data of 197 pregnant women with FGR(FGR group)and 75 healthy pregnant women(control group)who gave birth in the 2nd Affiliated Hospital of Chengdu Medical College,Nuclear Industry 416 Hospital from February 2019 to January 2022 were retrospectively analyzed.All patients received color Doppler ultrasound.All pregnant women were followed up to the pregnancy outcome.Logistic regression analysis was used to analyze the risk factors for poor pregnancy outcomes,and the prediction model was established and ROC curve was adopted to analyze the predictive value of the prediction model on poor pregnancy outcomes.Results The pulsatility index(PI),resistance index(RI)and systolic phase/diastolic phase(S/D)of umbilical artery and venous duct S/a value in FGR group were higher while the PI,RI and S/D of middle cerebral artery and S peak flow velocity and a peak flow velocity of venous duct were lower than those in control group(P＜0.05).Logistic regression analysis showed that poor pregnancy history,brain placenta rate＜1,abnormal spectrum of venous duct,PLGF lower than normal value,presence of pregnancy complications and intrauterine infection were risk factors for poor pregnancy outcomes(P＜0.05).The risk prediction model for poor pregnancy outcomes in pregnant women with FGR was obtained and represented as P=-1.053+0.492 x poor pregnancy history+0.635 x brain placental rate+0.473 x abnormal spectrum of venous duct+0.614 x PLGF+0.535 x pregnancy complications+0.821 x intrauterine infection.ROC curve revealed that the AUC,SE and 95％CI of the prediction model in predicting poor pregnancy outcomes in pregnant women with FGR were 0.929,0.022 and 0.886-0.973.Conclusions Pregnant women with FGR have abnormal blood flow phenomena in umbilical artery,middle cerebral artery and venous duct.The prediction model established according to the risk factors of poor outcomes in pregnant women with FGR has high predictive value on the occurrence of poor pregnancy outcomes.
关键词
胎儿生长受限/血流动力学/妊娠结局/预测模型
Key words
fetal growth restriction/hemodynamics/pregnancy outcomes/prediction model
维普
万方数据