Medina Castro Néstor, Figueroa Diesel Horacio, Guzmán Huerta Mario, Hernández Andrade Edgar
Unidad de Medicina Fetal, Departamento de Ginecología y Obstetricia del Hospital Materno Infantil Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España.
Ginecol Obstet Mex. 2006 Oct;74(10):509-15.
To establish the normal reference values of the pulsatility index in the uterine (UtA PI) and umbilical (UmA PI) arteries during pregnancy.
A total of 2081 normal pregnancies with normal growth fetuses were evaluated with pulsed Doppler ultrasound (US) between 20 and 40 weeks of gestation (WG). Both, UtA and UmA, were located with color Doppler US and PI measured in 5 consecutive and uniform cardiac cycles. In the uterine arteries, mean PI from the left and right arteries (Mean UtAPI) was calculated and the prevalence of unilateral or bilateral "notch" documented. Normal reference values for each gestational week were constructed, and reproducibility analyzed.
There was a negative correlation between the gestational age and PI values from both arteries (Mean UtAPI = 1.57 + -0.02 X WG, r2= 0.07; PI UmA = 1.56 + -0.02 X WG, r2= 0.15). The prevalence of unilateral and bilateral "notch" in the uterine arteries was (median) 5% (range 3-10%), and 17% (range 4-23%), respectively. Reproducibility analysis for calculation of the Mean UtAPI showed an intraclass and interclass correlation coefficients of 0.87 (95% confidence intervals [CI] 0.74 - 0.93) and 0.78 (95% CI 0.59-0.88), respectively, and for UmAPI, 0.97 (95% CI 0.93-0.98) and 0.94 (95% Cl 0.88-0.97), respectively. Agreement analysis between observers for the calculation of the Mean UtAPI showed a mean difference of 0.01 (SD, 0.13) (95% limits of agreement [95% LA] -0.27-0.28) and for the UmAPI mean difference of 0.04 (SD 0.16) (95% LA, -0.29 - 0.36).
The reference values here obtained of the mean UtA PI and UmAPI can be applied in the clinical surveillance of normal and complicated pregnancies.
建立孕期子宫动脉（UtA PI）和脐动脉（UmA PI）搏动指数的正常参考值。
采用脉冲多普勒超声（US）对2081例胎儿生长正常的正常妊娠孕妇进行评估，孕周为20至40周（WG）。通过彩色多普勒超声定位UtA和UmA，并在连续5个一致的心搏周期中测量PI。计算子宫动脉左右两侧的平均PI（Mean UtAPI），记录单侧或双侧“切迹”的发生率。构建每个孕周的正常参考值，并分析其可重复性。
孕周与两条动脉的PI值呈负相关（Mean UtAPI = 1.57 ± 0.02×WG，r2 = 0.07；PI UmA = 1.56 ± 0.02×WG，r2 = 0.15）。子宫动脉单侧和双侧“切迹”的发生率（中位数）分别为5%（范围3 - 10%）和17%（范围4 - 23%）。Mean UtAPI计算的可重复性分析显示，组内和组间相关系数分别为0.87（95%置信区间[CI] 0.74 - 0.93）和0.78（95% CI 0.59 - 0.88），UmAPI的组内和组间相关系数分别为0.97（95% CI 0.93 - 0.98）和0.94（95% Cl 0.88 - 0.97）。观察者之间计算Mean UtAPI的一致性分析显示平均差异为0.01（标准差，0.13）（95%一致性界限[95% LA] -0.27 - 0.28），UmAPI的平均差异为0.04（标准差0.16）（95% LA，-0.29 - 0.36）。
此处获得的Mean UtA PI和UmAPI参考值可应用于正常和复杂妊娠的临床监测。
