Fratelli N, Rampello S, Guala M, Platto C, Frusca T
Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy.
J Matern Fetal Neonatal Med. 2008 Jun;21(6):403-6. doi: 10.1080/14767050802053073.
To assess the value of early transabdominal uterine artery Doppler ultrasound for the prediction of gestational outcomes in pregnancies at high risk for preeclampsia.
This was an observational study. Doppler ultrasound of the uterine arteries at 11-14 weeks of gestation was performed in 76 women at high risk for preeclampsia. Abnormal uterine Doppler was defined by the presence of bilateral notching or by a mean resistance index (RI) >0.80. Adverse outcomes evaluated were preeclampsia, fetal growth restriction, placental abruption, intrauterine death, and complications requiring delivery before 34 weeks of gestation.
Among 76 women, 30 (39%) had abnormal uterine Doppler and 46 (61%) had normal Doppler waveform configuration and RI. Abnormal uterine flow was related to a significantly higher incidence of preeclampsia (17% vs. 0%; p = 0.0041), fetal growth restriction (27% vs. 0%; p = 0.0002), intrauterine death (13% vs. 0%; p = 0.0109), and iatrogenic preterm delivery (20% vs. 2%; p = 0.0086). When the Doppler was normal, the negative predictive value for complications requiring delivery before 34 weeks was 98%.
Normal impedance to flow in uterine arteries between 11 and 14 weeks of gestation is strongly related to a normal pregnancy outcome in women at high risk for preeclampsia.
评估早期经腹子宫动脉多普勒超声对预测子痫前期高危妊娠妊娠结局的价值。
这是一项观察性研究。对76例子痫前期高危孕妇在妊娠11 - 14周时进行子宫动脉多普勒超声检查。子宫多普勒异常定义为双侧切迹存在或平均阻力指数（RI）>0.80。评估的不良结局包括子痫前期、胎儿生长受限、胎盘早剥、宫内死亡以及妊娠34周前需要分娩的并发症。
76例孕妇中，30例（39%）子宫多普勒异常，46例（61%）多普勒波形形态和RI正常。子宫血流异常与子痫前期（17% vs. 0%；p = 0.0041）、胎儿生长受限（27% vs. 0%；p = 0.0002）、宫内死亡（13% vs. 0%；p = 0.0109）以及医源性早产（20% vs. 2%；p = 0.0086）的发生率显著升高相关。当多普勒正常时，妊娠34周前需要分娩的并发症的阴性预测值为98%。
妊娠11至14周子宫动脉血流阻抗正常与子痫前期高危孕妇的正常妊娠结局密切相关。
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