Schulman H, Ducey J, Farmakides G, Guzman E, Winter D, Penny B
Department of Obstetrics and Gynecology, Winthrop-University Hospital, Mineola, NY 11501.
Am J Obstet Gynecol. 1987 Dec;157(6):1539-42. doi: 10.1016/s0002-9378(87)80259-4.
Continuous wave Doppler studies were carried out on both uterine arteries in 71 pregnant women from the twentieth week of gestation onward. Analysis of the waveform included the systolic/diastolic ratio and the presence or absence of a diastolic notch. In the current study, these ratios from 31 women with left/right systolic/diastolic difference, (between left and right uterine arteries) were compared with those of women having normal ratios. A normal left/right systolic/diastolic ratio difference of 0.3 with SD of 0.3 was found. When the left/right difference was plotted against the left/right averaged systolic/diastolic ratio, a correlation coefficient of 0.7 was noted (p less than 0.001). Significant outcome differences were noted between normal and abnormal left/right difference systolic/diastolic ratios in the perinatal parameters of gestational age at delivery, fetal weight, pregnancy-induced hypertension, proteinuria, and intrauterine growth retardation. Divergent uterine artery ratio findings are a result of one artery being the dominant supplier to the placenta. The majority of women with an elevated systolic/diastolic ratio seem to have divergent uterine blood supply to the uterus and placenta. These data suggest that errors in placentation site contribute to the development of preeclampsia and growth retardation in the fetus.
对71名从妊娠20周起的孕妇的双侧子宫动脉进行了连续波多普勒研究。对波形的分析包括收缩期/舒张期比值以及舒张期切迹的有无。在本研究中，将31名左右子宫动脉收缩期/舒张期比值存在差异的女性的这些比值，与比值正常的女性的比值进行了比较。发现左右收缩期/舒张期比值的正常差异为0.3，标准差为0.3。当将左右差值与左右平均收缩期/舒张期比值作图时，发现相关系数为0.7（p小于0.001）。在分娩时的胎龄、胎儿体重、妊娠高血压、蛋白尿和宫内生长迟缓等围产期参数方面，正常和异常的左右收缩期/舒张期比值差异之间存在显著的结局差异。子宫动脉比值不同的结果是由于一条动脉是胎盘的主要供血者。大多数收缩期/舒张期比值升高的女性似乎子宫和胎盘的供血不同。这些数据表明，胎盘着床部位的异常导致了先兆子痫的发生和胎儿生长迟缓。
