Baghel Akanksha, Patekar Tejashree Y, Choorakuttil Rijo M, Sharma Lalit K, Satarkar Shilpa R, Gupta Anjali, Aneja Kavita, Dhankhar Sandhya, Chhajer Gulab, Dwivedi Somya, Jain Mansi, Shentar Srinivas, Nirmalan Praveen K
Department of Clinical Radiology, Baghel Sonography Center, Harda, Madhya Pradesh, India.
Department of Clinical Radiology, Innovision Sonography and Imaging Center, Gangapur, Nashik, Maharashtra, India.
Indian J Radiol Imaging. 2023 Jan 31;33(2):195-200. doi: 10.1055/s-0043-1761250. eCollection 2023 Apr.
The aim of this study was to determine the changes in the mean arterial blood pressure (MAP) and mean uterine artery (UtA) pulsatility index (PI) from 11-14 to 19-24 + 6 gestation weeks in Asian Indian pregnant women. Clinical and demographic details, MAP, and mean UtA PI measures were ascertained for pregnant women at 11 to 14 gestation weeks and 19-24 + 6 gestation weeks. Women were categorized as a high-or-low risk for preterm preeclampsia using the Fetal Medicine Foundation algorithm and 1 in 150 cutoff. High-risk pregnant women were recommended low-dose aspirin 150 mg daily at bedtime. Changes in MAP and mean UtA PI were compared for gestational age intervals and high-and-low risk women using nonparametric tests. The study analyzed the results of 1,163 pregnant women. Both MAP (mean difference: 5.14, < 0.001) and mean UtA PI (mean difference: 0.14, < 0.001) remained significantly higher at the second-trimester assessment in high-risk pregnant women compared to low-risk pregnant women. Seventy-seven (35.16%) of the 219 pregnant women with abnormal mean UtA PI in the first trimester had an abnormal mean UtA PI in the second-trimester assessment. One hundred (10.59%) of the 944 pregnant women with normal mean UtA PI in the first trimester had an abnormal mean UtA PI in the 19-24 + 6 weeks assessment. Seventy-seven pregnant women (6.62% of 1,163 women, 95% confidence interval: 5.33, 8.20) had an abnormal mean UtA PI at both gestation age intervals. High-risk pregnant women taking low-dose aspirin daily showed a larger reduction in mean UtA PI compared to high-risk pregnant women that did not report the use of low-dose aspirin (0.89 vs. 0.62, <0.001) MAP and mean UtA PI decreased significantly from the first to the second trimester of pregnancy. Sequential assessment of the MAP and mean UtA PI in the first and second trimesters of pregnancy will be useful for fetal radiologists in India to identify a subgroup of women with abnormal mean UtA PI at both trimesters that may need more intense surveillance and follow-up till childbirth.
本研究的目的是确定亚洲印度裔孕妇从妊娠11 - 14周到19 - 24⁺⁶周期间平均动脉血压（MAP）和平均子宫动脉（UtA）搏动指数（PI）的变化。 确定了妊娠11至14周和19 - 24⁺⁶周孕妇的临床和人口统计学细节、MAP以及平均UtA PI测量值。使用胎儿医学基金会算法和1/150的截断值将孕妇分为早产子痫前期高风险或低风险。建议高风险孕妇每天睡前服用150毫克低剂量阿司匹林。使用非参数检验比较了不同孕周区间以及高风险和低风险女性的MAP和平均UtA PI变化。 该研究分析了1163名孕妇的结果。与低风险孕妇相比，高风险孕妇在孕中期评估时的MAP（平均差异：5.14，<0.001）和平均UtA PI（平均差异：0.14，<0.001）仍显著更高。在孕早期平均UtA PI异常的219名孕妇中，有77名（35.16%）在孕中期评估时平均UtA PI仍异常。在孕早期平均UtA PI正常的944名孕妇中，有100名（10.59%）在19 - 24⁺⁶周评估时平均UtA PI异常。77名孕妇（占1163名孕妇的6.62%，95%置信区间：5.33，8.20）在两个孕周区间的平均UtA PI均异常。与未报告使用低剂量阿司匹林的高风险孕妇相比，每天服用低剂量阿司匹林的高风险孕妇平均UtA PI的降低幅度更大（0.89对0.62，<0.001） MAP和平均UtA PI在妊娠的第一个到第二个三个月期间显著下降。对印度的胎儿放射科医生来说，在妊娠的第一和第二个三个月期间对MAP和平均UtA PI进行连续评估，将有助于识别在两个三个月期间平均UtA PI均异常的一组女性，这些女性可能需要更密切的监测和随访直至分娩。
