探讨超声检测胎儿脐动脉（UA）和大脑中动脉（MCA）血流对胎儿宫内窘迫的诊断价值。

回顾性分析新疆生产建设兵团医院2020年3月至2021年10月收治的200例孕妇的病历资料，根据妊娠结局是否出现胎儿宫内窘迫分为正常组124例，窘迫组76例。记录并比较2组孕28~32⁺⁶周、孕33~36⁺⁶周胎儿UA与MCA血流指标［阻力指数（RI）、收缩期最大流速与舒张末期流速比值（S/D）］差异，采用ROC曲线分析UA与MCA联合以及UA与MCA血流指标（RI、S/D）单独应用诊断胎儿宫内窘迫的敏感度、特异度和ROC曲线下面积（AUC）。

窘迫组28~32⁺⁶周、33~36⁺⁶周UA血流RI、S/D明显高于正常组（P均＜0.05）；窘迫组28~32⁺⁶周、33~36⁺⁶周MCA血流RI、S/D明显低于正常组（P均＜0.05）。孕28周~32⁺⁶周UA与MCA联合诊断胎儿宫内窘迫的敏感度为96.05%，特异度为90.32%，AUC为0.978，高于UA与MCA血流指标单独应用（P均＜0.05）。孕33周~36⁺⁶周UA与MCA联合诊断胎儿宫内窘迫的敏感度为78.95%，特异度为87.90%，AUC为0.906，高于UA与MCA血流指标单独应用（P均＜0.05）。

UA联合MCA血流指标对胎儿宫内窘迫的诊断价值较高，对胎儿宫内窘迫的临床诊断及干预治疗具有重要意义。

To evaluate the value of ultrasound detection of fetal umbilical artery (UA) and middle cerebral artery (MCA) blood flow in the diagnosis of fetal intrauterine distress.

A retrospective analysis was conducted on the medical records of 200 pregnant women admitted to Xinjiang Production and Construction Corps Hospital from March 2020 to October 2021. They were divided into a normal group of 124 cases and a distress group of 76 cases based on whether fetal distress occurred during pregnancy. UA and MCA blood flow indicators (resistance index [RI] and ratio of maximum systolic flow velocity to end diastolic flow velocity [S/D ratio]) at 28-32 weeks and 33-36 weeks of pregnancy were recorded and compared between the two groups. The sensitivity, specificity, and area under the ROC curve (AUC) of UA and MCA blood flow indicators (RI and S/D ratio), alone or in combination, in diagnosing fetal distress were calculated.

The RI and S/D ratio of UA blood flow at 28-32 weeks and 33-36 weeks in the distress group were significantly higher than those in the normal group (P＜0.05), while the RI and S/D ratio of MCA blood flow in the distress group at 28-32 weeks and 33-36 weeks were significantly lower than those in the normal group (P＜0.05). The sensitivity, specificity, and AUC of the combination of UA and MCA blood flow indicators in the diagnosis of fetal distress at 28-32 weeks of pregnancy were 96.05%, 90.32%, and 0.978, respectively, which were higher than those of either UA or MCA blood flow indicators alone (P＜0.05). The sensitivity, specificity, and AUC of the combination of UA and MCA blood flow indicators in the diagnosis of fetal distress at 33-36 weeks of pregnancy were 78.95%, 87.90%, and 0.906 respectively, which were higher than those of either UA or MCA blood flow indicators alone (P＜0.05).

The combination of UA and MCA blood flow indicators has high diagnostic value for fetal intrauterine distress, and is of great significance for the clinical diagnosis and interventional treatment of fetal intrauterine distress.