Arrue M, García M, Rodriguez-Bengoa M T, Landa J M, Urbieta L, Maiztegui M, Salgueiro L, Belar M, Trecet J C, Lekuona A
a Department of Obstetrics and Gynecology , Donostia University Hospital , San Sebastian , Spain.
J Matern Fetal Neonatal Med. 2017 Apr;30(7):877-880. doi: 10.1080/14767058.2016.1190822. Epub 2016 Jun 8.
To evaluate uterine artery (UtA) Doppler over the course of pregnancy in low-risk nulliparous women and to analyze whether an abnormal uterine artery pulsatility index (UtA-PI) at a 32-34 week' scan implies poorer perinatal outcomes.
An observational prospective study was carried out including 616 low-risk nulliparous women. Women with any of the following were excluded: fetal abnormalities, multiple pregnancy, and heparin, metformin or hypotensive treatment. Maternal characteristics, mean arterial pressure measurements and UtA Doppler findings were recorded longitudinally.
Complete pregnancy data were available for 489/616 women (79.3%). Of these, 385 women had a normal UtA-PI throughout pregnancy (Group 0), while 50 (10.1%) had an UtA-PI > 95th percentile in the first or the second trimester that normalized in the third trimester (Group 1), and 56 (11.4%) had an abnormal UtA-PI in the third trimester (Group 2). We found that the rate of pre-eclampsia (PE) was higher in Group 2 (7/56 versus 4/435, p = 0.003) as was the rate of intrauterine growth restriction (IUGR) (6/56 versus 14/435, p = 0.02).
Low-risk nulliparous women with abnormal UtA Doppler findings in the third trimester are at a higher risk of developing PE and having a baby with IUGR.
评估低风险未生育女性孕期子宫动脉（UtA）多普勒情况，并分析孕32 - 34周超声检查时子宫动脉搏动指数（UtA-PI）异常是否意味着围产期结局较差。
开展一项前瞻性观察性研究，纳入616名低风险未生育女性。排除具有以下任何一种情况的女性：胎儿异常、多胎妊娠以及接受肝素、二甲双胍或降压治疗者。纵向记录产妇特征、平均动脉压测量值及子宫动脉多普勒检查结果。
489/616名女性（79.3%）有完整的孕期数据。其中，385名女性孕期UtA-PI均正常（第0组），50名（10.1%）在孕早期或孕中期UtA-PI高于第95百分位数，但在孕晚期恢复正常（第1组），56名（11.4%）在孕晚期UtA-PI异常（第2组）。我们发现，第2组子痫前期（PE）发生率更高（7/56 vs 4/435，p = 0.003），胎儿生长受限（IUGR）发生率也更高（6/56 vs 14/435，p = 0.02）。
孕晚期子宫动脉多普勒检查结果异常的低风险未生育女性发生子痫前期及胎儿生长受限的风险更高。
