Department of Obstetrics and Gynaecology, Maternal Fetal Medicine Unit, University of Brescia , Brescia , Italy.
Clin Exp Hypertens. 2015;37(1):57-62. doi: 10.3109/10641963.2014.897723. Epub 2014 Apr 30.
Doppler velocimetry is a non-invasive method to monitor pregnancies complicated by pre-eclampsia. We aimed to assess the predictive value of adverse perinatal or maternal outcome of three ratios, i.e. middle cerebral to umbilical arteries pulsatility indices (PI), middle cerebral to uterine arteries PI and uterine to umbilical arteries PI, compared with that of uterine and umbilical arteries PI in pre-eclamptic patients. This is a cohort study on 168 singleton pregnancies between January 2010 and June 2013. Doppler velocimetry was performed at the diagnosis of pre-eclampsia. Logistic regression analysis was performed and receiver-operating characteristics (ROC) curves were calculated to determine the predictive ability of each Doppler index. Multivariate analysis was run to adjust results for confounding parameters. Seventy-eight cases were complicated by adverse perinatal outcome, 79 by maternal one, 49 by both. Considering perinatal outcome, area under ROC curve was 0.730 for uterine arteries PI, 0.691 for umbilical artery PI and 0.834 for middle cerebral to uterine arteries PI ratio, while for maternal one 0.720 for uterine arteries PI, 0.686 for umbilical artery PI and 0.817 for middle cerebral to uterine arteries PI ratio. At multivariate analysis, only middle cerebral to uterine arteries PI ratio remain statistically significant for both outcomes (p = 0.001). The cited ratio appeared more accurate than all other considered indices in predicting perinatal and maternal outcomes in patients affected by pre-eclampsia.
多普勒速度测定法是一种非侵入性方法，可用于监测伴有先兆子痫的妊娠。我们旨在评估三种比值（大脑中动脉与脐动脉搏动指数、大脑中动脉与子宫动脉搏动指数以及子宫动脉与脐动脉搏动指数之比）与先兆子痫患者的子宫动脉和脐动脉搏动指数相比，对不良围产儿或母体结局的预测价值。这是一项在 2010 年 1 月至 2013 年 6 月期间对 168 例单胎妊娠进行的队列研究。在诊断先兆子痫时进行多普勒速度测定。进行逻辑回归分析，并计算接收者操作特征（ROC）曲线，以确定每个多普勒指数的预测能力。进行多元分析以调整混杂参数的结果。78 例病例伴有不良围产儿结局，79 例伴有母体结局，49 例同时伴有。考虑到围产儿结局，子宫动脉搏动指数的 ROC 曲线下面积为 0.730，脐动脉搏动指数为 0.691，大脑中动脉与子宫动脉搏动指数之比为 0.834，而对于母体结局，子宫动脉搏动指数为 0.720，脐动脉搏动指数为 0.686，大脑中动脉与子宫动脉搏动指数之比为 0.817。在多元分析中，只有大脑中动脉与子宫动脉搏动指数之比对于两种结局均具有统计学意义（p=0.001）。在预测患有先兆子痫的患者的围产儿和母体结局方面，该比值比所有其他考虑的指数都更准确。
