Pariente Gali, Shwarzman Paulina, Aricha-Tamir Barak, Weintraub Adi Y, Hershkovitz Reli
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences , Ben-Gurion University of the Negev , Israel and.
J Matern Fetal Neonatal Med. 2013 Nov;26(17):1724-7. doi: 10.3109/14767058.2013.798292. Epub 2013 May 17.
To evaluate the prevalence of first trimester vaginal bleeding among patients with abnormal second and third trimester uterine artery Doppler.
A prospective study of patients with a uterine artery Doppler measurement between 27 and 42 weeks' gestation was undertaken. A comparison was made between two groups: patients with and without first trimester vaginal bleeding. Abnormal uterine artery Doppler was defined as PI >95th% or the presence of a diastolic notch.
Of the 277 patients that were included in the study, 65 (23%) had first trimester vaginal bleeding. No differences were noted in uterine artery Doppler waveforms among patients with and without first trimester vaginal bleeding. Among patients with first trimester vaginal bleeding, 9 (14%) had a bilateral uterine artery notch and 56 (86%) did not, compared with 51 (24%) and 161 (76%), in the control group, respectively. Patients with first trimester vaginal bleeding, and a bilateral uterine artery notch had significantly higher rates of small for gestational age neonates, low-Apgar scores (<7) at one minute and cesarean deliveries compared to patients with first trimester vaginal bleeding who did not have bilateral uterine artery notch.
First trimester vaginal bleeding was not associated with a higher incidence of abnormal uterine artery waveforms or with placental related conditions. However, adverse perinatal outcomes were found when first trimester vaginal bleeding was associated with second and third trimester bilateral uterine artery notchs.
评估孕中期和孕晚期子宫动脉多普勒异常患者孕早期阴道出血的发生率。
对妊娠27至42周期间进行子宫动脉多普勒测量的患者进行前瞻性研究。比较两组：有和没有孕早期阴道出血的患者。子宫动脉多普勒异常定义为搏动指数（PI）>第95百分位数或存在舒张期切迹。
纳入研究的277例患者中，65例（23%）有孕早期阴道出血。有和没有孕早期阴道出血的患者子宫动脉多普勒波形无差异。在孕早期阴道出血的患者中，9例（14%）有双侧子宫动脉切迹，56例（86%）没有，而对照组分别为51例（24%）和161例（76%）。与没有双侧子宫动脉切迹的孕早期阴道出血患者相比，有双侧子宫动脉切迹的孕早期阴道出血患者小于胎龄儿、1分钟时阿氏评分低（<7分）和剖宫产的发生率显著更高。
孕早期阴道出血与子宫动脉波形异常或胎盘相关疾病的发生率较高无关。然而，当孕早期阴道出血与孕中期和孕晚期双侧子宫动脉切迹相关时，会发现不良围产期结局。
