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超声预测妊娠中晚期高血压孕妇胎儿发育异常。

Ultrasound prediction of abnormal infant development in hypertensive pregnant women in the second and third trimester.

机构信息

Department of Ultrasound in Medicine, Shanghai 6th People's Hospital affiliated to Shanghai Jiaotong University, No 600 Yishan Road, Shanghai 200233, PR China.

Department of Obstetrics and Gynecology, Shanghai 6th People's Hospital affiliated to Shanghai Jiaotong University, No 600 Yishan Road, Shanghai 200233, PR China.

出版信息

Sci Rep. 2017 Jan 16;7:40429. doi: 10.1038/srep40429.

Abstract

The objective was to assess the sensitivities and accuracies of Doppler ultrasound parameters in the second and third trimester of hypertensive pregnancies in determining perinatal outcomes. 1,054 pregnancies were retrospectively categorized into three groups (healthy pregnancies (HP, n = 988), pregnancies of hypertensive women (HypP, n = 30) and high-risk hypertension pregnancies (HRHypP, n = 36), depending on gestational hypertension as well as fetal birth weights and pregnancy outcomes. Systolic/diastolic ratio (S/D), resistance index (RI), pulsatility index (PI) of the bilateral uterine artery, umbilical artery and vein as well as venous flow velocity data were monitored by Doppler ultrasound. At 20-27 and 28-32 gestational weeks, uterine artery PIs and RIs were significantly higher in the HRHypP group than in the HP and HypP patients. At gestational weeks 20-27 and 28-32 left plus right PI data with cut-off values of 2.35 and 1.73 indicated a risk of stillbirth, premature pregnancy termination and a birth weight of less than 2,500 g with sensitivities of 94.4% and 93.1% as well as specificities of 95.2% and 90.1%, respectively.

摘要

目的是评估高血压妊娠中晚期多普勒超声参数在预测围产结局方面的灵敏度和准确性。将 1054 例妊娠病例回顾性分为三组(健康妊娠组(HP),n=988 例;高血压孕妇妊娠组(HypP),n=30 例;高危高血压妊娠组(HRHypP),n=36 例),根据妊娠期高血压、胎儿出生体重和妊娠结局进行分组。通过多普勒超声监测双侧子宫动脉、脐动脉和脐静脉的收缩期/舒张期比值(S/D)、阻力指数(RI)、搏动指数(PI)及静脉血流速度数据。在 20-27 周和 28-32 周时,HRHypP 组的子宫动脉 PI 和 RI 明显高于 HP 和 HypP 组。在 20-27 周和 28-32 周时,左加右 PI 值截断值为 2.35 和 1.73,可提示死胎、早产和出生体重小于 2500g 的风险,其灵敏度分别为 94.4%和 93.1%,特异性分别为 95.2%和 90.1%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7eb/5238445/44c37a731883/srep40429-f1.jpg

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