脑胎盘子宫比在预测胎儿生长受限中的应用价值

doi:10.12280/gjfckx.20250234

摘要/Abstract

摘要：

胎儿生长受限（fetal growth restriction，FGR）是一种与不良妊娠结局密切相关的妊娠并发症，其早期诊断和监测对改善预后至关重要。近年研究发现，脑胎盘子宫比（cerebral-placental-uterine ratio，CPUR）作为一种新兴的多普勒超声参数，通过整合胎儿大脑中动脉、脐动脉和子宫动脉的血流动力学指标，在预测FGR中展现出显著优势。CPUR对早发型和晚发型FGR均具有较高的预测潜力，尤其在晚发型FGR中，部分研究表明CPUR的预测效能优于传统血流指标，且与手术分娩、围产儿死亡等不良妊娠结局显著相关。此外，CPUR对妊娠期高血压和妊娠前糖尿病患者的不良围产结局的预测价值也得到初步验证。综述CPUR在FGR中的应用价值及研究进展，旨在通过CPUR对FGR高危胎儿进行早期诊断和合理监测，减少FGR不良妊娠结局的发生，并为CPUR的临床推广和个体化干预提供理论依据。

关键词: 胎儿生长迟缓, 超声检查, 多普勒, 妊娠结局, 产前诊断, 预测, 脑胎盘子宫比

Abstract:

Fetal growth restriction (FGR) is a pregnancy complication closely associated with adverse pregnancy outcomes. Early diagnosis and monitoring of FGR are crucial for improving prognosis. In recent years, studies have found that the cerebral-placental-uterine ratio (CPUR), as a novel Doppler ultrasound parameter, shows significant advantages in predicting FGR by integrating the hemodynamic indicators of the fetal middle cerebral artery, umbilical artery, and uterine artery. CPUR has high predictive potential for both early-onset and late-onset FGR. Particularly in late-onset FGR, some studies have shown that the predictive efficacy of CPUR is superior to that of traditional blood flow indicators, and it is significantly associated with adverse pregnancy outcomes such as operative delivery and perinatal mortality. In addition, the predictive value of CPUR for adverse perinatal outcomes in patients with hypertensive disorders of pregnancy and pregestational diabetes has also been preliminarily validated. This review summarizes the application value and research progress of CPUR in FGR, aiming to achieve early diagnosis and rational monitoring of high-risk fetuses with FGR though CPUR, reduce the occurrence of adverse pregnancy outcomes of FGR, and provide a theoretical basis for the clinical promotion and individualized intervention of CPUR.

Key words: Fetal growth retardation, Ultrasonography, Doppler, Pregnancy outcomes, Prenatal diagnosis, Prediction, Cerebral-placental-uterine ratio

姜云霞, 李佳慧, 李想, 夏明雪, 杨淑莉. 脑胎盘子宫比在预测胎儿生长受限中的应用价值[J]. 国际妇产科学杂志, 2025, 52(4): 371-376.

JIANG Yun-xia, LI Jia-hui, LI Xiang, XIA Ming-xue, YANG Shu-li. Application Value of the Cerebral-Placental-Uterine Ratio in Predicting Fetal Growth Restriction[J]. Journal of International Obstetrics and Gynecology, 2025, 52(4): 371-376.

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