Department of Obstetrics and Gynecology, University Hospital of Bologna, Bologna, Italy.
Ultrasound Obstet Gynecol. 2010 Nov;36(5):577-81. doi: 10.1002/uog.7602.
To evaluate whether the persistence of abnormal findings in the third trimester following increased uterine artery (UtA) resistance in the second trimester is related to adverse pregnancy outcome.
Low-risk nulliparous women with increased UtA mean pulsatility index (PI) at 20-22 weeks underwent repeat Doppler interrogation at 26-28 weeks and were divided into two groups: those with persistently abnormal Doppler and those with normalized UtA findings. Pregnancy outcome was noted for all patients and compared with that of 104 controls.
We examined 104 women with increased UtA resistance in the second trimester and in 62 (59.6%) cases the abnormal uteroplacental Doppler findings persisted to 26-28 weeks. Compared with controls and with patients with normalized Doppler at the third-trimester scan, patients with persistently abnormal Doppler results had a significantly higher risk of pre-eclampsia (10/62 vs. 1/104, P = 0.002 and 10/62 vs. 1/42, P = 0.047, respectively), small-for-gestational age (SGA) fetus (20/62 vs. 1/104, P < 0.001 and 20/62 vs. 4/42; P = 0.007, respectively) and admission of the infant to a neonatal intensive care unit (16/62 vs. 4/104; P < 0.001 and 16/62 vs. 1/42; P < 0.001, respectively). Compared with controls, cases with normalization had an increased risk of SGA (4/42 vs. 1/104, P = 0.03), but there were no significant differences for the other outcome measures.
In low-risk nulliparous women with increased UtA resistance in the second trimester, the persistence of abnormal Doppler findings at 26-28 weeks is associated with an increased risk of obstetric complications when compared with both controls and patients with third-trimester Doppler normalization.
评估在妊娠中期子宫动脉（UtA）阻力增加后第三个月持续存在异常发现是否与不良妊娠结局有关。
低危初产妇在妊娠 20-22 周时 UtA 平均搏动指数（PI）升高，在妊娠 26-28 周时行重复多普勒检查，分为两组：持续存在异常多普勒组和 UtA 结果正常组。记录所有患者的妊娠结局并与 104 例对照进行比较。
我们检查了 104 例妊娠中期 UtA 阻力增加的孕妇，其中 62 例（59.6%）异常的胎盘血流多普勒发现持续到妊娠 26-28 周。与对照组和妊娠晚期多普勒扫描正常的患者相比，持续存在异常多普勒结果的患者发生子痫前期的风险显著增加（10/62 例比 1/104 例，P=0.002 和 10/62 例比 1/42 例，P=0.047），胎儿小于胎龄（SGA）（20/62 例比 1/104 例，P<0.001 和 20/62 例比 4/42 例，P=0.007），婴儿需要入住新生儿重症监护病房（16/62 例比 4/104 例，P<0.001 和 16/62 例比 1/42 例，P<0.001）。与对照组相比，正常化组 SGA 风险增加（4/42 例比 1/104 例，P=0.03），但其他结局指标无显著差异。
在妊娠中期 UtA 阻力增加的低危初产妇中，与对照组和妊娠晚期多普勒正常化的患者相比，妊娠 26-28 周时持续存在异常多普勒发现与产科并发症风险增加相关。
