The value of fetal aortic isthmus flow index combined with middle cerebral artery pulsatility index in predicting fetal distress in patients with preeclampsia

LI Xingyue; YANG Ruimin; WANG Likun; WANG Yicheng; JIAO Guiqing; HUANG Jiacheng; MA Yue

Abstract：Objective To explore the value of fetal aortic isthmus flow index(IFI)combined with the pulsatility index of middle cerebral artery(PIMCA)in predicting fetal distress in preeclampsia(PE).Methods 121cases of pregnant women with PE were selected.The IFI and the PIMCAof all fetuses were measured.The birth outcomes of all fetuses were followed up and di-vided into distress group and non-distress group according to clinical diagnosis.The PIMCA and IFI were compared between the two groups.ROC curve and Logistic regression were used to analyze the predictive efficacy of the PIMCA and IFI in predicting fetal distress in PE and to analyze the value of their combined application.Results The PIMCA of the fetuses in distress group was lower than that of the non-distress group,and the IFI of the fetuses in distress group was lower than that in the non-distress group,with statistical significance(P<0.05).PIMCA and IFI can predict fetal distress in PE patients,with cut-off values of 1.30(sensitivity,64.6%,specificity,89.0%)and 0.91(sensitivity,68.8%,specificity,80.8%).The sensitivity and specificity of PIMCA combined with IFI in predicting fetal distress were 85.4%and 72.6%.Logistic regression analysis showed that PIMCA<1.30 and IFI<0.91 could significantly predict the occurrence of fetal distress in PE,and the OR values were 12.889 and 6.706,both of which were statistically significant(P<0.05).The area under the curve of IFI in predicting fetal distress was 0.793(95%CI:0.710～0.861)and the area under the curve of PIMCA in predicting fetal distress was 0.819(95%CI:0.738～0.883).The area un-der the curve of IFI combined with PIMCA in predicting fetal distress was 0.890(95%CI:0.820～0.939).The area under the curve of IFI combined with PIMCAwas higher than that both alone in predicting fetal distress,there was statistically significant(P<0.05).Conclusions The PIMCA and IFI of fetus can be used to predict fetal distress and detect the condition of fetus.IFI combined with PIMCA has high prediction efficiency for fetal distress in PE.