摘要
目的 观察早产子痫前期患者胎儿的脐动脉(UA)及大脑中动脉(MCA)相关血流动力学参数,探讨其与妊娠结局的关系。方法 根据病情严重程度,将分娩孕周<37周的子痫前期孕妇分为轻度组和重度组,记录两组母体并发症及新生儿不良妊娠结局的发生情况;选取同时期于我院分娩的健康孕产妇作为对照组,比较三组患者的脐动脉及大脑中动脉的阻力指数(RI)、搏动指数(PI)及收缩期峰值流速与舒张期末期流速的比值(S/D),并计算脑胎盘率(CPR)。比较各组不良妊娠结局的发生率及新生儿相关指标,根据妊娠结局分为不良结局组与非不良结局组,比较两组患者临床资料;通过二分类Logistic回归分析超声血流动力学与新生儿预后的相关性。结果 3组胎儿UA的PI、RI、S/D水平由高到低为重度组、轻度组、对照组,MCA的PI、RI、S/D水平由高到低为对照组、轻度组、重度组,组间差异均有统计学意义(P<0.001)。对照组、轻度组、重度组的不良妊娠结局发生率分别为7.5%(3/40)、25.0%(10/40)、37.5%(15/40),3组差异有统计学意义(χ~2=10.155,P<0.001)。回归分析结果显示,UA(PI、RI、S/D)、MCA(PI、RI、S/D)及CPR均与围生儿不良预后相关(P<0.05)。结论 胎儿脐动脉及大脑中动脉相关血流动力学指标对于预测早产子痫前期患者发生不良妊娠结局有一定的临床价值。
Objective Observing the umbilical artery(UA) and middle cerebral artery(MCA) hemodynamic parameters in patients with preterm preeclampsia,and exploring their relationship with pregnancy outcomes.Methods According to the severity of the condition,pregnant women with preeclampsia delivering before 37 weeks of gestation were divided into mild and severe groups.The occurrence of maternal complications and adverse pregnancy outcomes in both groups was recorded.Healthy pregnant women who delivered at the same period in our hospital were selected as the control group.The resistance index(RI),pulsatility index(PI),the ratio of peak systolic velocity to end-diastolic velocity(S/D),and the cerebral-placental ratio(CPR) of the umbilical artery and middle cerebral artery were compared among the three groups.The occurrence rate of adverse pregnancy outcomes and neonatal-related indicators were compared among the groups.According to the pregnancy outcomes,patients were divided into adverse outcome group and non-adverse outcome group,and the clinical data of the two groups were compared.Logistic regression analysis was performed to evaluate the correlation between ultrasound hemodynamics and neonatal prognosis.Results The levels of PI,RI,and S/D in the umbilical artery(UA) were highest in the severe group,followed by the mild group,and lowest in the control group.The levels of PI,RI,and S/D in the middle cerebral artery(MCA) were highest in the control group,followed by the mild group,and lowest in the severe group.The differences among the groups were statistically significant(P<0.001).The occurrence rates of adverse pregnancy outcomes in the control group,mild group,and severe group were 7.5%(3/40),25.0%(10/40),and 37.5%(15/40),respectively.The differences among the three groups were statistically significant(χ~2=10.155,P<0.001).Regression analysis showed that UA(PI,RI,S/D),MCA(PI,RI,S/D),and CPR were all correlated with poor prognosis in perinatal infants(P<0.05).Conclusions The hemodynamic parameters of the umbilical artery and middle cerebral artery in fetuses have certain clinical value in predicting adverse pregnancy outcomes in patients with preterm preeclampsia.
作者
杨倩
高霞
YANG Qian;GAO Xia(The Third Clinical College,Hubei University of Medicine,Shiyan 442000,China;Department of Obstetrics,Affiliated People s Hospital,Hubei University of Medicine,Shiyan 442000,China)
出处
《健康研究》
CAS
2024年第2期213-217,共5页
Health Research
关键词
早产
子痫前期
多普勒超声
妊娠结局
预测
preterm
preeclampsia
doppler ultrasound
pregnancy outcomes
prediction
