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孕产妇病史和子宫动脉波形在早发型和晚发型子痫前期预测中的作用:一项队列研究

Maternal history and uterine artery wave form in the prediction of early-onset and late-onset preeclampsia: A cohort study.

作者信息

Sharma Nidhi, Jayashree Krishnamurthy, Nadhamuni Kulasekaran

机构信息

Department of Obstetrics and Gynaecology, Saveetha Medical College, Chennai, India.

Department of Radiology, Saveetha Medical College, Chennai, India.

出版信息

Int J Reprod Biomed. 2018 Feb;16(2):109-114.

Abstract

BACKGROUND

Pregnancy induced hypertension (PIH) is a significant cause of maternal morbidity and mortality. Pregnancy-induced-hypertension can be prevented by identification of prenatal and antenatal factors. The uterine artery Doppler waveform transforms into a high flow with low resistance at 22-24 wk.

OBJECTIVE

To study the maternal risk factors and uterine artery Doppler waveform in singleton mid-trimester pregnancy and predict the occurrence of pregnancy-induced hypertension

MATERIALS AND METHODS

This is a cohort study comprising of Doppler ultrasound examination of the uterine arteries at 20-23 wk gestation in 697 women with singleton pregnancies attending a routine target scan. The pregnant women were followed up. PIH was recorded in 57 (8.18%) of all pregnancies

RESULTS

Maternal age >34 yr, primiparity, the presence of chronic hypertension was also associated with increased risk of PIH. High pulsatility index (>95 percentile) as compared to low pulsatility index was a good tool for the detection of PIH (sensitivity 91.23% and specificity 99.06%, p<0.05). Presence of high pulsatility was a significant risk factor for early-onset PIH as compared to late-onset PIH.

CONCLUSION

Uterine artery Doppler can be safely performed at the time of routine target anomaly scan in the second trimester. It is simple, economical, feasible and with good detection rates.

摘要

背景

妊娠高血压综合征(PIH)是孕产妇发病和死亡的重要原因。通过识别产前和产时因素可预防妊娠高血压。子宫动脉多普勒波形在孕22 - 24周时转变为高流量低阻力状态。

目的

研究单胎妊娠中期孕妇的危险因素及子宫动脉多普勒波形,并预测妊娠高血压的发生。

材料与方法

这是一项队列研究,对697名单胎妊娠孕妇在妊娠20 - 23周时进行子宫动脉多普勒超声检查,这些孕妇均接受常规的目标扫描,并对其进行随访。所有妊娠中57例(8.18%)记录有PIH。

结果

产妇年龄>34岁、初产、存在慢性高血压也与PIH风险增加相关。与低搏动指数相比,高搏动指数(>第95百分位数)是检测PIH的良好工具(敏感性91.23%,特异性99.06%,p<0.05)。与晚发型PIH相比,高搏动指数的存在是早发型PIH的重要危险因素。

结论

在孕中期进行常规目标异常扫描时可安全地进行子宫动脉多普勒检查。它简单、经济、可行且检出率高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b07/5899825/d6dda676b814/ijrb-16-109-g001.jpg

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