Papageorghiou Aris T, Leslie Karin
St George's, University of London, London, UK bFetal Medicine Unit, St George's Hospital, London, UK.
Curr Opin Obstet Gynecol. 2007 Apr;19(2):103-9. doi: 10.1097/GCO.0b013e32809bd964.
To review publications, published during the past year, that have examined uterine artery Doppler findings in women with adverse pregnancy outcome.
Almost two-thirds of stillbirths that occur in the early preterm period (up to 32 weeks) can be predicted by uterine artery Doppler at 23 weeks. First trimester screening studies have shown that an abnormal result increases the risk of subsequent fetal growth restriction, and such women are at particularly high risk when indices remain abnormal in the second trimester. Studies combining uterine artery Doppler with maternal serum markers have demonstrated that measurement of first-trimester maternal serum pregnancy-associated plasma protein A and free beta human chorionic gonadotrophin improve sensitivities of second-trimester Doppler. As these are frequently measured in Down syndrome screening and they lend themselves in screening for pre-eclampsia. Women with abnormal first and second-trimester serum markers constitute a high-risk group. Maternal serum placental protein 13 remains a promising method for early screening, although a recent study suggests lower sensitivities than initially reported.
Uterine artery Doppler screening identifies women at high risk for developing adverse pregnancy outcomes. Detection rates may be increased and false positive rates reduced by combination with maternal characteristics or serum markers.
回顾过去一年发表的有关研究不良妊娠结局女性子宫动脉多普勒检查结果的文献。
23周时的子宫动脉多普勒检查可预测近三分之二发生在早产早期（至32周）的死产。孕早期筛查研究表明，异常结果会增加随后胎儿生长受限的风险，而当这些指标在孕中期仍异常时，此类女性风险尤其高。将子宫动脉多普勒与母体血清标志物相结合的研究表明，孕早期母体血清妊娠相关血浆蛋白A和游离β人绒毛膜促性腺激素的检测可提高孕中期多普勒检查的敏感性。由于这些指标常在唐氏综合征筛查中检测，且有助于子痫前期的筛查。孕早期和孕中期血清标志物异常的女性构成高危组。母体血清胎盘蛋白13仍是一种有前景的早期筛查方法，尽管最近一项研究显示其敏感性低于最初报道。
子宫动脉多普勒筛查可识别出发生不良妊娠结局风险高的女性。结合母体特征或血清标志物可提高检出率并降低假阳性率。
