目的 :探讨脐血流 S/ D<3范围内出现异常波形的临床意义。方法 :应用彩色超声多普勒脐血流分析仪对 61 2例孕晚期妇女进行产前胎儿脐动脉血流监测 ,观察 S/ D<3范围内异常波形的围产儿结局 ,并与 S/ D<3图形正常组以及 S/ D≥ 3组相比较 ,分析其围产儿结局的差异。结果 :1 S/ D<3异常图形组围产儿发生宫内缺氧、发育不良、畸形、新生儿窒息以及胎盘老化 ,脐带扭转、打结、缠绕、羊水过少、羊水污染等不同程度 ,不同类型的异常 ,围产儿异常的发生率明显高于 S/ D<3正常图形组 ( P<0 .0 1 ) ;与 S/ D≥ 3组相比较 ,两组围产儿异常发生率虽无显著性差异 ( P>0 .0 5) ,但两组新生儿窒息率却相差显著 ,S/ D≥ 3组明显增高 ( P<0 .0 5) ,且其围产儿并发症多 ,症状重 ,预后也差。 2 S/ D<3范围内 ,异常图形诊断围产儿异常的敏感性为 73 .6% ,特异性 94.2 % ,尤登指数为 0 .74。结论 ;妊娠晚期胎儿脐动脉血流 S/ D值虽在正常范围 ( S/ D<3 ) ,但图形异常仍提示胎儿 -胎盘循环不良 ,可以作为早期诊断胎儿宫内异常的指标 ,从而指导产科处理 ,一旦 S/ D比值上升 ,则表明胎儿 -胎盘循环已严重不足 ,往往治疗效果较差 ,应引起临床重视 Objective: To investigate the clinical significance of abnormal waveform in cord blood flow S / D <3. Methods: Prenatal fetal umbilical artery blood flow monitoring was performed on 61 2 pregnant women with color Doppler umbilical cord blood flow analyzer. The perinatal outcome of abnormal waveforms in S / D <3 range was observed and compared with S / D <3 normal control group and S / D≥3 group compared to analyze the differences in their perinatal outcomes. Results: Intrauterine hypoxia, hypoplasia, deformity, neonatal asphyxia and placental aging, umbilical cord twisting, knotting, wrapping, oligohydramnios, amniotic fluid contamination and so on were all different in 1 S / D <3 abnormal graph group Type of abnormalities, the incidence of perinatal abnormalities was significantly higher than the S / D <3 normal group (P <0.01); compared with the S / D≥3 group, the incidence of abnormalities in two groups of no significant difference (P 0.05). However, the rates of neonatal asphyxia were significantly different between the two groups (P <0.05), and there were more perinatal complications, severe symptoms, The prognosis is poor. In the range of 2 S / D <3, the sensitivity of abnormal patterns in diagnosing perinatal abnormalities was 73.6%, the specificity was 94.2%, and the Youden index was 0.74. Conclusions: Although the S / D value of fetal umbilical artery blood flow in the third trimester of pregnancy is in the normal range (S / D <3), the abnormality of the fetus still indicates the abnormal fetal-placental circulation, which can be used as an early indicator of fetal abnormalities to guide the obstetric Treatment, once the S / D ratio increases, indicating that fetal-placental circulation has been seriously inadequate, often less effective treatment, should cause clinical attention