The clinical value of spectral Doppler ultrasound in evaluating the trend of blood flow in fetal growth restriction

WANG Yuan; LIN Yingqi; ZHOU Qinying; LIU Wei; FENG Ying; QIAN Linxue

doi:10.20258/j.cnki.1006-9011.2025.06.001

Abstract：Objective To investigate the trend of hemodynamic parameters of umbilical artery and middle cerebral artery in fetal growth restriction(FGR)by spectral Doppler ultrasound from the second to third trimester.Methods A total of 170 preg-nant women who were registered and gave birth.All were single fetuses.Among the 70 fetuses suspected of FGR by prenatal ultra-sound examination,62 were clinically confirmed as FGR after birth,which was the FGR group.The control group was 100 fe-tuses with normal weight predicted by prenatal ultrasound examination and within the normal range after birth.Each pregnant woman underwent three examinations at 21-27 weeks,28-33 weeks,and 34-40 weeks of pregnancy,respectively.Doppler ultra-sound was used to detect the pulsatility index(PI),resistance index(RI)and ratio of peak systolic velocity to end-diastolic ve-locity(S/D)of fetal umbilical artery(UA)and middle cerebral artery(MCA),and peak systolic velocity(PSV)of MCA.The cerebroplacental ratio(CPR)was calculated,and the changing trends between the two groups were compared.Results In the FGR group and control group,the PI,RI and S/D of UA decreased with the increase of gestational weeks,the PI,RI and S/D of MCA increased with the increase of gestational weeks from 21 to 28 weeks,reached a peak at 29 to 31 weeks,and decreased with the increase of gestational weeks after 32 weeks,and the PSV of MCA increased with the increase of gestational weeks.The CPR increased with the increase of gestational weeks at 21-30 weeks,reached a peak at 31-34 weeks,and decreased with the in-crease of gestational weeks after 35 weeks.After 32 weeks of gestation,the trend lines of PI,RI and S/D of fetal UA in FGR group were higher than those in control group(all P<0.05),the trend lines of PI,RI and S/D of fetal MCA in FGR group were lower than those in control group(all P<0.05),the trend lines of PSV were higher than those in control group(P<0.05),and the trend lines of CPR were lower than those in control group,with no statistical significance(P>0.05).Conclusion After 32 weeks of gestation,there were some differences in the blood flow resistance,PSV and CPR of the umbilical artery and middle ce-rebral artery of the fetus with FGR compared with that of the fetus with normal pregnancy.Although the significance was not strong,the trend lines drawn were of certain significance for the judgment and follow-up of FGR,and for assisting clinical effec-tive obstetric management.