Roncaglia Nadia, Crippa Isabella, Locatelli Anna, Cameroni Irene, Orsenigo Francesca, Vergani Patrizia, Ghidini Alessandro
Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy.
Prenat Diagn. 2008 Aug;28(8):710-4. doi: 10.1002/pd.2027.
To assess the role of uterine artery (UtA) Doppler to predict superimposed preeclampsia in women with chronic hypertension.
In a cohort of 182 women with chronic hypertension, UtA Doppler studies were performed before 25 weeks (mean 19.7 +/- 2.1 weeks) and repeated later in pregnancy (mean 28.5 +/- 3.7 weeks).
The incidence of preeclampsia was 13% (24/182). Rates of preeclampsia increased with advancing gestation of abnormal UtA Doppler: 7% when UtA Doppler were normal at early exam, 18% when abnormal at early exam, and 28% when abnormal at late exam (Chi-square for trend: P < 0.001). The rate of preeclampsia among 40 women with abnormal early but normal late UtA Doppler was similar to that of women with normal findings at early exam (8 vs 7%; P = 1.00). Logistic regression analysis showed that the ability of UtA Doppler to predict preeclampsia was independent from other variables [Odds Ratio (OR) 7.1, 95% Confidence Interval (CI) 2.6-18.9). Receiver operating characteristic (ROC) curve identified a UtA value of 0.58 as the optimal threshold for the prediction of preeclampsia.
The later in pregnancy the abnormal UtA Doppler findings are observed, the greater the risk of preeclampsia. Normalization of UtA Doppler after 25 weeks reduces the risk of preeclampsia to 8%.
评估子宫动脉（UtA）多普勒超声在预测慢性高血压女性并发子痫前期中的作用。
对182例慢性高血压女性进行队列研究，在孕25周前（平均19.7±2.1周）进行UtA多普勒超声检查，并在妊娠后期（平均28.5±3.7周）重复检查。
子痫前期的发生率为13%（24/182）。子痫前期的发生率随着UtA多普勒超声异常时孕周的增加而升高：早期检查UtA多普勒超声正常时为7%，早期检查异常时为18%，晚期检查异常时为28%（趋势卡方检验：P<0.001）。40例早期UtA多普勒超声异常但晚期正常的女性子痫前期发生率与早期检查正常的女性相似（8%对7%；P=1.00）。逻辑回归分析显示，UtA多普勒超声预测子痫前期的能力独立于其他变量[比值比（OR）7.1，95%置信区间（CI）2.6 - 18.9]。受试者工作特征（ROC）曲线确定UtA值为0.58是预测子痫前期的最佳阈值。
妊娠后期观察到UtA多普勒超声异常，子痫前期风险越高。25周后UtA多普勒超声恢复正常可将子痫前期风险降至8%。
