Relationship between fetal heart rate, the changes of blood flow parameters of aortic arch isthmus and umbilical vein catheter and adverse pregnancy outcomes of the fetus in high risk late pregnancy
Han Mingyan, Wang Xinnan, Wang Hong, et al
Department of Ultrasound Diagnosis,Chengde Central Hospital, Hebei, Chengde 067000, China; 2. Nuclear Magnetic Laboratory, Chengde CentralHospital, Hebei, Chengde 067000, China; 3. Physical Examination Center, Chengde Central Hospital, Hebei, Chengde 067000, China)
Abstract: 【Abstract】 Objective To investigate the relationship between fetal heart rate, the changes of blood flow parameters of aortic arch isthmus (Aol) and umbilical venous catheter (UVC) and adverse pregnancy outcomes of the fetus in high-risk late pregnancy. Method Using retrospective analysis method, 129 pregnant women with high-risk pregnancy in the third trimester admitted to Chengde Central Hospital from August 2019 to August 2022 were selected as the high-risk group, and 129 cases with normal pregnancy in the third trimester were selected as the control group. The fetal heart rate, blood flow parameters of Aol [end-systolic reflux velocity (ESRV), peak systolic velocity (PSV), PSV/ESRV], UVC [pulsatility index (PI), preload index (PLI), peak velocity during ventricular systole (S), peak velocity index vein (PVIV), peak velocity during ventricular diastole (D), velocity during atria systole (A)] of the fetus were compared and analyzed between the two groups. The pregnancy outcomes were followed up. The differences of fetal heart rate, blood flow parameters of Aol and UVC of the fetus between the good pregnancy outcome group and the poor pregnancy outcome group in pregnant women with highrisk pregnancy were compared and analyzed, and their relationship with adverse pregnancy outcomes and diagnostic value were analyzed. Statistical methods performed by t-test, χ2 test, multivariate Logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Result The fetal heart rate of the high-risk group was higher than that in the control group [(155.39±29.44) times/min vs(141.38±17.20) times/min, t=4.667, P<0.001], and the ESRV of Aol was higher than that in the control group[(36.67±3.50) ml/min vs (28.73±3.31) ml/min, t=18.720, P<0.001], PSV/ESRV was lower than that in thecontrol group (2.93±0.59 vs 4.16±0.76, t=14.520, P<0.001), PI, PVIV and PLI of UVC were higher than those in the control group, A, S, D were lower than those in the control group, and the incidence of adverse pregnancy outcomes was higher than that in the control group (39.53% vs 5.43%, χ2=43.059, P<0.001). In the fetus of high-risk late pregnancy the fetal heart rate in the poor pregnancy outcome group was higher than that in the good pregnancy outcome group [(161.72±29.66) times/min vs (139.23±17.14) times/min, t=7.457, P<0.001], and the ESRV of Aol was higher than that in the good pregnancy outcome group[(37.89±3.34) ml/min vs (31.55±3.21) ml/min, t=10.794, P<0.001]. PSV/ESRV was lower than that in the good pregnancy outcome group (2.73±0.59 vs 3.51±0.69, t=6.639, P<0.001). The PI, PVIV and PLI of UVC were higher than those in the good pregnancy outcome group, A, S and D were lower than those in the good pregnancy outcome group (all P<0.05). Multivariate Logistic regression analysis showed that abnormal fetal heart rate, Aol and UVC blood flow parameters in high-risk late pregnancy were related to adverse pregnancy outcomes (P<0.05). The results of ROC curve analysis showed that abnormal fetal heart rate, Aol and UVC blood flow parameters of high-risk pregnant fetus had high diagnostic value for adverse pregnancy outcomes (all AUC>0.700 ). The diagnostic value of ESRV in Aol was the highest (AUC=0.876), and the diagnostic value of PI in UVC was the second (AUC=0.842). The diagnostic value of abnormal fetal heart rate was lower than the first two (AUC=0.762). Conclusion The abnormal fetal heart rate , Aol and UVC blood flow parameters of the fetus in the third trimester of high-risk pregnancy are related to adverse pregnancy outcomes.
韩明妍 王鑫楠 王洪 杜薇 杜建文 胡媛. 高危妊娠晚期胎儿胎心率、主动脉弓峡部及脐静脉导管的血流参数变化与不良妊娠结局的关系[J]. 发育医学电子杂志, 2025, 13(1): 40-46.
Han Mingyan, Wang Xinnan, Wang Hong, et al. Relationship between fetal heart rate, the changes of blood flow parameters of aortic arch isthmus and umbilical vein catheter and adverse pregnancy outcomes of the fetus in high risk late pregnancy. Journal of Developmental Medicine(Electronic Version), 2025, 13(1): 40-46.
2025, Vol. 13 
