Diagnostic Value of Transcranial Ultrasound-Measured Middle Cerebral Artery S/D and RI for Fetal Distress in Late Pregnancy
CHEN Wei
WANG Junyan
CHENG Hui
ZHAO Bo
Abstract：Objective To explore the diagnostic value of transcranial ultrasound in assessing the peak systolic velocity/end diastolic velocity ratio(S/D)and resistance index(RI)in the middle cerebral artery for intrauterine fetal distress during late pregnancy.Methods A total of 200 pregnant women in the late pregnancy who underwent prenatal examination at Changzhi People's Hospital between December 2022 and December 2023 were selected.Based on the occurrence of fetal intrauterine distress,they were divided into an intrauterine distress group(44 cases)and a non-intrauterine distress group(156 cases).The differences in middle cerebral artery S/D,RI,Apgar score,and pregnancy outcomes were compared between the two groups.Pearson correlation analysis was used to examine the relationship between middle cerebral artery S/D,RI,and Apgar score.ROC curves were employed to evaluate the diagnostic value of S/D,RI,and their combination for intrauterine distress in late pregnancy.The intrauterine distress group was further divided into a subgroup with adverse pregnancy outcomes(12 cases)and a subgroup with favorable pregnancy outcomes(32 cases)based on pregnancy outcomes.Differences in middle cerebral artery S/D and RI during late pregnancy were analyzed among intrauterine distress cases with different pregnancy outcomes.Results Compared with the non-intrauterine distress group,the intrauterine distress group showed significantly lower middle cerebral artery S/D,RI,and Apgar scores[(3.41±1.07)vs(4.86±1.34),P<0.01;(0.67±0.13)vs(0.80±0.12),P<0.01;(6.00±1.71)points vs(8.92±0.69)points,P<0.01].Pearson correlation analysis indicated that both S/D and RI were positively correlated with Apgar score,and S/D was positively correlated with RI(P<0.01).ROC curve analysis revealed that the AUC for the combined diagnosis of fetal intrauterine distress in late pregnancy was 0.798,which was significantly higher than that of S/D(0.751)or RI(0.769)alone(P<0.05).The intrauterine distress group had higher rates of preterm birth,amniotic fluid contamination,and neonatal asphyxia compared to the non-intrauterine distress group(P<0.05).The subgroup with favorable pregnancy outcomes exhibited higher S/D,RI,and Apgar scores than the subgroup with adverse pregnancy outcomes(P<0.01).Conclusion Transcranial ultrasound assessment of S/D and RI in the middle cerebral artery has certain value in diagnosing intrauterine distress during late pregnancy.The combined use of both parameters offers higher diagnostic value and is correlated with pregnancy outcomes.
Keywords：fetal distressfetuslate pregnancytranscranial ultrasoundmiddle cerebral arterypeak systolic velocity/end diastolic velocity ratioresistance index
Publication Date：2025-10-20
Online Publishing Date：2025-10-28(First online date of this platform, not the publication date of the document)
Pages：5( 106-110 )