Kang Xiaomin, Wang Tongfei, He Liyin, Xu Haijing, Liu Zhilan, Zhao Aimin
Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China.
J Ultrasound Med. 2016 Dec;35(12):2583-2587. doi: 10.7863/ultra.16.01020. Epub 2016 Oct 25.
The purpose of this study was to evaluate differences in uterine artery blood flow parameters and pregnancy outcomes, if any. An investigation was conducted to determine the effects of low-dose aspirin on uterine artery blood flow indices in patients with recurrent pregnancy loss.
This observational study included 353 Chinese women with a history of recurrent pregnancy loss and 85 women without a history of recurrent pregnancy loss (control group) from Ren Ji Hospital. All patients were scanned transvaginally with transvaginal Doppler sonography 6 to 8 days after ovulation to measure the pulsatility index (PI), resistive index (RI), and systolic-to-diastolic ratio (S/D) of the left and right main uterine arteries. Low-dose aspirin at a dose of 50 mg/d was administered orally in patients with recurrent pregnancy loss for 2 months, and the blood flow indices were measured subsequently. The Student t test was used for analysis of the results, P < .05 was considered significant.
The mean PI and S/D of the uterine arteries in the recurrent pregnancy loss group were significantly higher than in the control group. Although not statistically significant, the RI was higher in the recurrent pregnancy loss group than the control group. Moreover, the PI and S/D increased as the number of pregnancy losses increased. Significant enhancements of the PI and S/D were observed in patients with 4 or more consecutive abortions. After low-dose aspirin supplementation, patients with recurrent pregnancy loss showed a highly significant reduction in the PI and S/D.
Uterine blood flow decreased during the luteal phase in patients with recurrent pregnancy loss. Low-dose aspirin induced a reversible increase in uterine blood flow and may be of therapeutic value.
本研究旨在评估子宫动脉血流参数及妊娠结局(若有差异)。开展一项调查以确定低剂量阿司匹林对复发性流产患者子宫动脉血流指数的影响。
这项观察性研究纳入了来自仁济医院的353名有复发性流产病史的中国女性以及85名无复发性流产病史的女性(对照组)。所有患者在排卵后6至8天接受经阴道多普勒超声检查,以测量左右主子宫动脉的搏动指数(PI)、阻力指数(RI)和收缩期与舒张期比值(S/D)。有复发性流产病史的患者口服50mg/d的低剂量阿司匹林,持续2个月,随后测量血流指数。采用Student t检验分析结果,P <.05被认为具有统计学意义。
复发性流产组子宫动脉的平均PI和S/D显著高于对照组。虽然无统计学意义,但复发性流产组的RI高于对照组。此外,PI和S/D随着流产次数的增加而升高。在连续流产4次或更多次的患者中观察到PI和S/D有显著升高。补充低剂量阿司匹林后,复发性流产患者的PI和S/D显著降低。
复发性流产患者在黄体期子宫血流减少。低剂量阿司匹林可使子宫血流可逆性增加,可能具有治疗价值。