Brown M A, North L, Hargood J
Department of Renal Medicine, St George Hospital, Sydney, Australia.
Aust N Z J Obstet Gynaecol. 1990 Nov;30(4):303-7. doi: 10.1111/j.1479-828x.1990.tb02015.x.
Three hundred and five pregnant women referred consecutively from a single antenatal clinic for imaging ultrasound after 26 weeks' gestation had doppler velocimetry of umbilical artery, uterine artery and umbilical vein. Results of doppler studies were not available to clinicians until after delivery and clinical case records were examined postpartum for the development of pregnancy-induced hypertension (PIH) or gestational diabetes mellitus (DM) and for fetal outcome. Accurate data were available for 272 women, of whom 167 had a normal pregnancy, 61 had or developed PIH and 44 had or developed DM. None of the various doppler velocimetry measurements differed significantly amongst these 3 groups at any gestational stage. Abnormal values for doppler systolic: diastolic (A/B) ratio were found in only 7% of umbilical artery measurements, 6% of uterine artery measurements and none of umbilical vein measurements. Specificity of abnormal results for PIH or DM was high (95-97%) but sensitivity low (16-17%) and positive and negative predictive values were generally low. Two perinatal deaths occurred and umbilical artery A/B ratio was abnormal in both cases. This study shows that there is a low yield of abnormal results for doppler velocimetry of umbilical artery, uterine artery or umbilical vein in routine antenatal screening.
305名在妊娠26周后从单一产前诊所连续转诊来进行超声成像检查的孕妇接受了脐动脉、子宫动脉和脐静脉的多普勒血流速度测定。直到分娩后临床医生才能获得多普勒研究结果，产后检查临床病例记录以了解妊娠高血压（PIH）或妊娠期糖尿病（DM）的发生情况以及胎儿结局。272名女性有准确数据，其中167名妊娠正常，61名患有或发生了PIH，44名患有或发生了DM。在任何妊娠阶段，这三组之间的各种多普勒血流速度测定值均无显著差异。仅7%的脐动脉测量、6%的子宫动脉测量出现多普勒收缩压与舒张压（A/B）比值异常，脐静脉测量均未出现异常。PIH或DM异常结果的特异性较高（95 - 97%），但敏感性较低（16 - 17%），阳性和阴性预测值总体较低。发生了2例围产期死亡，两例脐动脉A/B比值均异常。本研究表明，在常规产前筛查中，脐动脉、子宫动脉或脐静脉的多普勒血流速度测定异常结果的检出率较低。
