Value and Significance of Prenatal Doppler Ultrasonography in Evaluating the Changes of Blood Flow Parameters in Fetal Growth Restriction

WEI Xiaodong; QUAN Zhenhua; ZHANG Xueyan; WU Xinhua

doi:10.3969/j.issn.1002-3429.2023.12.025

Abstract：Objective To investigate the changes of blood flow parameters in fetal growth restriction(FGR)with Doppler ultrasound,and to analyze its diagnostic value and clinical significance.Methods A total of 71 pregnant women diag-nosed with FGR from January 2022 to June 2023 were selected as the case group,and 71 pregnant women with small gestational age were selected as the control group during the same period.The blood flow parameters[peak systolic flow velocity/end-dias-tolic flow velocity(S/D),pulse index(PI),peak ventricular systolic flow velocity/atrial systolic valley A-wave flow velocity(S/a)and cerebroplacental ratio(CPR)]of fetal umbilical artery(UA),middle cerebral artery(MCA),ductus venosus(DV)and maternal uterine artery(UtA)in the two groups were analyzed.Multivariate Logistic regression analysis was used to screen the influencing factors of FGR,and the complex models with and without Doppler ultrasound blood flow parameters were constructed respectively.The diagnostic efficacy of Doppler ultrasound blood flow parameters for FGR was analyzed by receiver operating characteristic(ROC)curve.Decision curve and clinical impact curve were used to evaluate the clinical benefits and advantages of the composite model of Doppler ultrasound blood flow parameters.Results There were significant differences in UA-S/D,UA-PI,MCA-PI,UtA-PI,DV-S/a and CPR between case group and control group(P<0.01).Maternal age,com-plications during pregnancy,adverse pregnancy history,birth weight of the newborn,abnormal placenta and umbilical cord of the newborn,UA-S/D,UA-PI,MCA-PI,UtA-PI,DV-S/a and CPR were the influencing factors for the incidence of FGR(P<0.05,P<0.01).The area under the ROC curve of combined detection of Doppler ultrasound blood flow parameters in the diag-nosis of FGR was higher than that of UA-S/D,UA-PI,MCA-PI,UtA-PI,DV-S/a and CPR alone(P<0.05).There was posi-tive net benefit in the diagnosis of FGR by composite model of Doppler ultrasound blood flow parameters.The threshold probabil-ity value was in the range of 0.6-1.0,and the composite model of Doppler ultrasound blood flow parameters had a high coinci-dence rate in the diagnosis of FGR.Conclusion Prenatal Doppler ultrasound was used to detect abnormal fetal blood flow pa-rameters of FGR.The combined detection of UA-S/D,UA-PI,MCA-PI,UtA-PI,DV-S/a and CPR has certain diagnostic value for FGR,and has good clinical benefit,which can provide evidence for early clinical screening and intervention.