Souza Alex Sandro Rolland, Vasconcelos Neto Mário José, Cunha Adriana Scavuzzi Carneiro da, Monteiro Eveline de Fátima Catão, Amorim Melania Maria Ramos de
Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil.
Rev Bras Ginecol Obstet. 2011 Apr;33(4):157-63.
to determine the best Doppler flow velocimetry index to predict small infants for gestational age (SGAI), in pregnant women with hypertensive syndromes.
a cross-sectional study was conducted enrolling 129 women with high blood pressure, submitted to doppler velocimetry up to 15 days before delivery. Women with multiple fetuses, fetal malformations, genital bleeding, placental abruption, premature rupture of fetal membranes, smoking, use of illicit drugs, and chronic diseases were excluded. A receiver operating characteristic (ROC) curve for each Doppler variable was constructed to diagnose SGAI and the sensitivity (Se), specificity (Sp), positive (PLR) and negative (NLR) likelihood ratio were calculated.
the area under the ROC curve for the middle cerebral artery resistance index was 52% (p=0.79) with Se, Sp, PLR, and NLR of 25.0, 89.1, 2.3 and 0.84% for a resistance index lower than 0.70, respectively. While the area under the ROC curve for the resistance index of the umbilical artery was 74% (p=0.0001), with Se=50.0%, Sp=90.0%, PLR=5.0 and NLR=0.56, for a resistance index higher or equal to 0.70. The area under the ROC curve for the resistance index umbilical artery/middle cerebral artery ratio was 75% (p=0.0001). When it was higher than 0.86, the Se, Sp, PLR and NLR were 70.8, 80.0, 3.4 and 0.36%, respectively. For the resistance index of the middle cerebral artery/uterine artery ratio, the area under the ROC curve was 71% (p=0.0001). We found a Se=52.2%, Sp=85.9%, PLR=3.7 and NLR=0.56, when the ratio was lower than 1.05. When we compared the area under the ROC curve of the four doppler velocimetry indexes, we observed that only the resistance index umbilical artery/middle cerebral artery, resistance index middle cerebral artery/uterine artery and resistance index umbilical artery ratios seem to be useful for the prediction of SGA.
in patients with high blood pressure during pregnancy, all doppler velocimetry parameters, except the middle cerebral artery resistance index, can be used to predict SGAI. The umbilical artery/middle cerebral artery ratio seems to be the most recommended one.
确定预测患有高血压综合征孕妇中小于胎龄儿（SGAI）的最佳多普勒血流速度测定指标。
进行一项横断面研究，纳入129名高血压女性，在分娩前15天内接受多普勒血流速度测定。排除怀有多胎、胎儿畸形、生殖道出血、胎盘早剥、胎膜早破、吸烟、使用违禁药物及患有慢性病的女性。构建每个多普勒变量的受试者工作特征（ROC）曲线以诊断SGAI，并计算敏感性（Se）、特异性（Sp）、阳性似然比（PLR）和阴性似然比（NLR）。
大脑中动脉阻力指数的ROC曲线下面积为52%（p = 0.79），当阻力指数低于0.70时，Se、Sp、PLR和NLR分别为25.0%、89.1%、2.3和0.84%。而脐动脉阻力指数的ROC曲线下面积为74%（p = 0.0001），当阻力指数大于或等于0.70时，Se = 50.0%，Sp = 90.0%，PLR = 5.0，NLR = 0.56。脐动脉/大脑中动脉阻力指数比值的ROC曲线下面积为75%（p = 0.0001）。当该比值高于0.86时，Se、Sp、PLR和NLR分别为70.8%、80.0%、3.4和0.36%。大脑中动脉/子宫动脉阻力指数比值的ROC曲线下面积为71%（p = 0.0001）。当该比值低于1.05时，Se = 52.2%，Sp = 85.9%，PLR = 3.7，NLR = 0.56。当比较四个多普勒血流速度测定指标的ROC曲线下面积时，我们观察到只有脐动脉/大脑中动脉阻力指数、大脑中动脉/子宫动脉阻力指数和脐动脉阻力指数比值似乎可用于预测小于胎龄儿。
在妊娠期高血压患者中，除大脑中动脉阻力指数外，所有多普勒血流速度测定参数均可用于预测小于胎龄儿。脐动脉/大脑中动脉比值似乎是最值得推荐的指标。
