De Paco Catalina, Ventura Walter, Oliva Raquel, Miguel Myriam, Arteaga Alicia, Nieto Anibal, Delgado Juan L
Fetal Medicine Unit, Clinic University Hospital 'Virgen de la Arrixaca', Murcia, Spain.
Prenat Diagn. 2014 Jul;34(7):711-5. doi: 10.1002/pd.4367. Epub 2014 Apr 16.
The aim of this study was to determine the clinical utility of Doppler assessment of the umbilical artery in the second trimester scan for predicting adverse pregnancy outcomes.
Singleton pregnancies that had undergone routine anomaly scan at 19 to 22 weeks of gestation with umbilical and uterine artery Doppler measurements. Receiver operating characteristic curves were constructed to evaluate the ability of umbilical artery pulsatility index (PI) to predict small for gestational age and preeclampsia.
The final study population comprised 4565 singleton pregnancies. Multiple regression analysis showed significant independent contribution of umbilical artery PI in predicting SGA <10th and SGA <5th centiles (adjusted odds ratios of 2.51 and 3.51, respectively). By using a cutoff of umbilical artery PI >90th centile, the likelihood ratio of SGA <5th centile is 2.3 (95% CI: 1.7-3.0).
Umbilical artery PI at 19 to 22 weeks of gestation is significantly associated with SGA below the tenth and fifth centiles. A multivariate model combining umbilical and uterine artery Doppler measurements with additional maternal and sonographic characteristics may help predict small for gestational age, particularly those below the fifth centile.
本研究旨在确定孕中期超声检查时脐动脉多普勒评估对预测不良妊娠结局的临床实用性。
对妊娠19至22周进行常规畸形扫描并测量脐动脉和子宫动脉多普勒的单胎妊娠进行研究。绘制受试者工作特征曲线，以评估脐动脉搏动指数（PI）预测小于胎龄儿和先兆子痫的能力。
最终研究人群包括4565例单胎妊娠。多元回归分析显示，脐动脉PI在预测小于第10百分位数和小于第5百分位数的小于胎龄儿方面有显著的独立贡献（调整后的比值比分别为2.51和3.51）。采用脐动脉PI>第90百分位数作为截断值时，小于第5百分位数的小于胎龄儿的似然比为2.3（95%可信区间：1.7 - 3.0）。
妊娠19至22周时的脐动脉PI与低于第10和第5百分位数的小于胎龄儿显著相关。将脐动脉和子宫动脉多普勒测量结果与其他母体和超声特征相结合的多变量模型可能有助于预测小于胎龄儿，尤其是低于第5百分位数的小于胎龄儿。
