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评估子宫动脉多普勒和低剂量阿司匹林对母婴结局的影响:印度西部低风险孕妇的前瞻性研究。

Assessing the Impact of Uterine Artery Doppler and Low-Dose Aspirin on Fetomaternal Outcome: A Prospective Study in Low-Risk Pregnant Women in Western Part of India.

作者信息

Patel Rashmi B, Patel Ajay K, Machave Manish Y, Tandulwadkar Sunita R, Lodha Puja A, Mondal Himel

机构信息

Obstetrics and Gynecology, All India Institute of Medical Sciences, Deoghar, Jharkhand, IND.

Anatomy, All India Institute of Medical Sciences, Deoghar, Jharkhand, IND.

出版信息

Cureus. 2023 Jul 26;15(7):e42515. doi: 10.7759/cureus.42515. eCollection 2023 Jul.

DOI:10.7759/cureus.42515
PMID:37637656
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10457434/
Abstract

Introduction Fetal growth restriction (FGR) and pregnancy-induced hypertension (PIH) are significant and clinically relevant complications observed in many pregnancies. Early prediction of these complications may be possible through the assessment of the umbilical artery pulsatility index (UAPI). However, its utility in routine practice for otherwise normal pregnancy needs further exploration in India. Objectives This study aimed to evaluate the potential benefits of incorporating UAPI for the timely use of low-dose aspirin in preventing FGR and PIH in a tertiary care hospital in the western part of India. Methodology A prospective study was conducted involving 64 low-risk (i.e., not having any feature of high-risk pregnancy) pregnant women selected from routine antenatal care outpatient departments over a period of two years. All women underwent uterine artery Doppler examination during the 11-13+6 weeks of pregnancy and those who had high UAPI received low-dose (150 mg) aspirin till the 35th week. The incidence of FGR and PIH was analyzed and compared between high UAPI and normal UAPI pregnancy. Results A total of 64 pregnant women with a mean age of 27.11±4 years participated in the study. Among the women, eight (12.5%) were found to have high UAPI and were put on aspirin. Among those eight women, two developed PIH. In the normal UAPI group, nine (16.07%) developed PIH (p-value = 0.62). FGR was found in one case among the eight who received aspirin and in eight cases among the 56 who had normal UAPI (p-value > 0.99). Conclusion The study concluded that despite having normal UAPI, women categorized as low-risk may develop PIH and FGR. Hence, the routine use of UAPI should be investigated in further cohort studies using a large sample to draw a generalizable conclusion for the Indian population.

摘要

引言 胎儿生长受限(FGR)和妊娠期高血压疾病(PIH)是许多妊娠中观察到的重要且具有临床相关性的并发症。通过评估脐动脉搏动指数(UAPI)可能实现对这些并发症的早期预测。然而,其在印度正常妊娠的常规实践中的效用需要进一步探索。

目的 本研究旨在评估在印度西部一家三级护理医院中,纳入UAPI以便及时使用小剂量阿司匹林预防FGR和PIH的潜在益处。

方法 进行了一项前瞻性研究,涉及从常规产前门诊在两年期间选取的64名低风险(即没有任何高危妊娠特征)孕妇。所有女性在妊娠11 - 13⁺⁶周期间接受子宫动脉多普勒检查,UAPI高的女性接受小剂量(150毫克)阿司匹林直至第35周。分析并比较了UAPI高和UAPI正常的妊娠中FGR和PIH的发生率。

结果 共有64名平均年龄为27.11±4岁的孕妇参与了研究。在这些女性中,发现8名(12.5%)UAPI高并服用了阿司匹林。在这八名女性中,两名发生了PIH。在UAPI正常组中,9名(16.07%)发生了PIH(p值 = 0.62)。在接受阿司匹林的8名女性中有1例发生FGR,在UAPI正常的56名女性中有8例发生FGR(p值>0.99)。

结论 该研究得出结论,尽管UAPI正常,但被归类为低风险的女性仍可能发生PIH和FGR。因此,应在进一步的队列研究中使用大样本对UAPI的常规使用进行调查,以便为印度人群得出可推广的结论。

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本文引用的文献

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PLoS One. 2022 Oct 19;17(10):e0275129. doi: 10.1371/journal.pone.0275129. eCollection 2022.
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Reference ranges of uterine artery pulsatility index from first to third trimester based on serial Doppler measurements: longitudinal cohort study.基于连续多普勒测量的早、中孕期子宫动脉搏动指数参考范围:纵向队列研究。
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Comparison of the Mean Uterine Artery Pulsatility Index Global Reference with an Asian Indian Population of Pregnant Women in the Samrakshan Program-Differences and Implications.在“Samrakshan计划”中,将子宫动脉搏动指数全球均值参考标准与亚洲印度裔孕妇群体进行比较——差异与启示
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A Review of Roles of Uterine Artery Doppler in Pregnancy Complications.子宫动脉多普勒在妊娠并发症中的作用综述
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Fetal Growth Restriction.胎儿生长受限
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Hypertensive disorders in pregnancy.妊娠期高血压疾病
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