Arabin B, Jimenez E, Vogel M, Weitzel H K
Department of Obstetrics and Gynecology, Klinikum Steglitz, Free University of Berlin, FRG.
Fetal Diagn Ther. 1992;7(3-4):173-9. doi: 10.1159/000263695.
Pulsed Doppler examinations were performed in 143 risk pregnancies. The resistance index (RI) values of the uteroplacental vessels and umbilical artery on the last examination before delivery were correlated to specific patterns of morphological placental findings. The sensitivity and specificity of Doppler blood flow velocity wave forms to predict placental disease as well as the significant relationships were calculated. Impaired uteroplacental perfusion is correlated with: disturbances in growth, such as reduced weight and reduced basal area (p < 0.005, p < 0.05); disturbances in villous maturation, such as prematurity or a reduction in intermediate sized villi (p < 0.05, p < 0.01), and circulation disorders, such as acute or chronic infarcts (p < 0.05), villous fibrosis (p < 0.005) or microfibrin deposits (p < 0.05). Villous immaturity was not correlated to either pathological utero- or fetoplacental blood flow. Except for acute infarcts, all these findings as well as endangiopathy of truncal arteries are also combined with high RI values in umbilical arteries (p < 0.005) possibly reflecting the 'down-stream impedance' of the fetoplacental circulation.
对143例高危妊娠进行了脉冲多普勒检查。分娩前最后一次检查时子宫胎盘血管和脐动脉的阻力指数(RI)值与胎盘形态学检查的特定模式相关。计算了多普勒血流速度波形预测胎盘疾病的敏感性和特异性以及显著相关性。子宫胎盘灌注受损与以下情况相关:生长障碍,如体重减轻和基底面积减小(p<0.005,p<0.05);绒毛成熟障碍,如早产或中等大小绒毛减少(p<0.05,p<0.01),以及循环障碍,如急性或慢性梗死(p<0.05)、绒毛纤维化(p<0.005)或微纤维蛋白沉积(p<0.05)。绒毛不成熟与病理性子宫或胎儿胎盘血流均无相关性。除急性梗死外,所有这些发现以及主干动脉的血管病变也与脐动脉的高RI值相关(p<0.005),这可能反映了胎儿胎盘循环的“下游阻抗”。