关键词: 胎儿生长受限, 胎盘血管灌注不良, 脐动脉, 血流动力学, 影响因素, 搏动指数

Abstract: Objective To explore and analysis the influencing factors of poor placental vascular perfusion in fetal growth restriction (FGR) mothers. Methods From January 2022 to January 2023, 87 cases of pregnant women who delivered in the First Hospital of Peking University Hospital, Ningxia Women's and Children's Hospital, Ningxia Hui Autonomous Region Maternal and Child Health Care Hospital and Child Health Care Hospital and were diagnosed with fetal growth restriction were selected as the study subjects. All the pregnant women were examined by ultrasound, and the hemodynamic parameters of umbilical artery were recorded. At the same time, all pregnant women were subjected to placental pathological examination, and were to determine the occurrence of poor placental vascular perfusion in the mother, investigated the general information of the pregnant women, and conducted correlation analysis. Results There were 27 cases were diagnosed as maternal placental vascular hypoperfusion, accountied for 31.0% (hypoperfusion group) in the 87 cases, included 14 cases of villous infarction, 6 cases of distal villous dysplasia, 4 cases of accelerated villous maturation, and 3 cases of decidual artery disease. There were significant difference in the history of preeclampsia and placental abruption compared between the two groups (P<0.05). There were no significant difference compared between the two groups in the peak systolic velocity of fetal umbilical artery (P>0.05). The end diastolic blood flow velocity in the hypoperfusion group were lower than that in the non hypoperfusion group (P<0.05), and the pulsation index and resistance index were higher than those in the non hypoperfusion group (P<0.05). Spearman analysis showed that maternal placental vascular perfusion were correlated with umbilical artery end diastolic blood flow velocity, pulsation index, resistance index, etc. in the 87 cases (P<0.05). Binary logistic regression analysis showed that umbilical artery end diastolic blood flow velocity, pulsation index and resistance index were important factors leading to poor vascular perfusion of the mother placenta (P<0.05). Conclusion The incidence of poor maternal placental vascular perfusion in FGR mothers is relatively high. The umbilical artery end diastolic blood flow velocity, pulsation index and resistance index are important factors leading to poor maternal placental vascular perfusion. Maternal placental vascular perfusion can provide basis for treatment and improvement of the prognosis of fetal growth restriction.

Key words: fetal growth restriction, poor placental vascular perfusion, umbilical artery, hemodynamics, influencing factors, pulsatile index