低母体大脑中动脉多普勒阻力指数可预测子痫前期的未来发展。

Low maternal middle cerebral artery Doppler resistance indices can predict future development of pre-eclampsia.

机构信息

Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA.

出版信息

Ultrasound Obstet Gynecol. 2012 Oct;40(4):406-11. doi: 10.1002/uog.11078.

DOI:10.1002/uog.11078

PMID:22173946

Abstract

OBJECTIVE

To determine if decreased resistance (vasodilatation) in the maternal middle cerebral artery (MCA) in the second trimester can predict third-trimester development of pre-eclampsia.

METHODS

Four-hundred and five low-risk gravidas had MCA transcranial Doppler (TCD) once in the second trimester. Maternal/neonatal outcomes were evaluated after delivery. Mean blood pressure, MCA velocities, resistance index (RI), pulsatility index (PI) and cerebral perfusion pressure (CPP) were compared between normotensive and pre-eclamptic cohorts.

RESULTS

Seven subjects (1.7%) developed pre-eclampsia. An RI of < 0.54 and a PI of < 0.81 were clinically useful in predicting subsequent pre-eclampsia. Areas under the receiver-operating characteristics curves for RI and PI were 0.93 and 0.93, respectively, with optimal sensitivity and specificity of 86% and 93% for both variables. Positive and negative likelihood ratios were 11.8/0.15 (RI) and 12.3/0.15 (PI).

CONCLUSION

TCD indices of low maternal MCA resistance in the second trimester are predictive of the subsequent development of pre-eclampsia in a low-risk, ethnically homogeneous population.

摘要

目的

确定母体大脑中动脉（MCA）在中期阻力（血管舒张）下降是否可以预测子痫前期在晚期的发展。

方法

405 例低危孕妇在中期进行了一次 MCA 经颅多普勒（TCD）检查。分娩后评估母婴结局。比较正常血压组和子痫前期组的平均血压、MCA 速度、阻力指数（RI）、搏动指数（PI）和脑灌注压（CPP）。

结果

7 例（1.7%）发生子痫前期。RI<0.54 和 PI<0.81 具有预测随后子痫前期的临床意义。RI 和 PI 的受试者工作特征曲线下面积分别为 0.93 和 0.93，两个变量的最佳灵敏度和特异性分别为 86%和 93%。阳性和阴性似然比分别为 11.8/0.15（RI）和 12.3/0.15（PI）。