Department of Obstetrics and Gynecology, Hospital General de Granollers, Barcelona, Spain.
Faculty of Medicine, International University of Catalunya (UIC), Barcelona, Spain.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):6586-6592. doi: 10.1080/14767058.2021.1918090. Epub 2021 May 12.
To assess the value of the second trimester mean pulsatility index of the uterine arteries (MPI-UtA) to predict adverse perinatal outcome (APO) in women with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS).
Pregnancies with either an SLE diagnosis or with primary APS controlled at our Hospital during a 10 years period were included. MPI-UtA was performed between 19-23 weeks' gestation. The MPI-UtA was defined as abnormal when it was >95 centile. APO was defined as the presence of: preeclampsia (PE), small for gestational age (SGA) newborn, preterm delivery, placental abruption and fetal or neonatal death.
There were 39 ongoing pregnancies, 16 of them with SLE and 23 with primary APS. Nine patients had no previous pregnancy (23%). Globally, 35 live births were recorded, being the mean gestational age at delivery 38.1 ± 2.1 weeks and the mean birth weight 2835 ± 492 g. Abnormal MPI-UtA was found in 6 (15%) pregnancies, all of them (100%) had an APO: there were 4 fetal deaths and 2 further severe PE with live newborn. Normal MPI-UtA was shown in the remaining 33 (84.6%); of them, 6 (18%) had an APO: one late PE with a premature newborn, another one severe preterm baby and 4 SGA term newborns. No cases of perinatal death occurred in this group. Therefore, accuracy of MPI-UtA evaluation for APO was: sensitivity 50%, specificity 100%, PPV 100% and NPV 82%, respectively ( < .001).
Abnormal second-trimester uterine artery Doppler evaluation is highly predictive for adverse perinatal outcome in pregnancies affected by SLE or APS.
评估中期妊娠子宫动脉搏动指数（MPI-UtA）对系统性红斑狼疮（SLE）和/或抗磷脂综合征（APS）患者不良围生期结局（APO）的预测价值。
纳入 10 年间在我院诊治的妊娠 SLE 患者或初发 APS 患者。在妊娠 19-23 周时进行子宫动脉多普勒检测。当 MPI-UtA 超过 95 百分位数时，定义为异常。APO 定义为存在以下情况：子痫前期（PE）、胎儿生长受限（SGA）、早产、胎盘早剥和胎儿或新生儿死亡。
共纳入 39 例妊娠，其中 16 例为 SLE，23 例为原发性 APS。9 例患者（23%）无既往妊娠史。总的来说，记录到 35 例活产，分娩时的平均孕龄为 38.1±2.1 周，平均出生体重为 2835±492g。6 例（15%）妊娠发现异常 MPI-UtA，均存在 APO（100%）：4 例胎儿死亡，2 例进一步发生严重 PE 合并活产新生儿。其余 33 例（84.6%）MPI-UtA 正常，其中 6 例（18%）发生 APO：1 例晚期 PE 合并早产新生儿，1 例严重早产婴儿，4 例足月 SGA 新生儿。该组无围产儿死亡病例。因此，MPI-UtA 对 APO 的评估准确性为：敏感性 50%，特异性 100%，PPV 100%和 NPV 82%（ < .001）。
中期妊娠子宫动脉多普勒评估异常对 SLE 或 APS 患者的不良围生期结局具有高度预测价值。
