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联合母体心脏做功与胎儿胎盘循环参数在检测子痫前期孕妇胎儿宫内缺氧中的诊断价值

Diagnostic value of combined maternal cardiac work and fetoplacental circulation parameters in detecting fetal intrauterine hypoxia in preeclamptic women.

作者信息

Du Jinghao, Zhao Jing, Li Wanyan, Wang Lihong

机构信息

Binzhou Medical University, 346 Guanhai Road, Yantai, 264003, Shandong, China.

Department of Ultrasound and electrocardiography, Dajijia Hospital, Yantai, Shandong, China.

出版信息

Sci Rep. 2024 Dec 28;14(1):31209. doi: 10.1038/s41598-024-82545-x.

Abstract

To investigate the correlation between fetoplacental circulation and maternal left ventricular myocardial work (MW) parameters in patients with preeclampsia (PE) and the prediction of fetal hypoxia. Seventy-eight PE patients (PE group) were assigned to intrauterine-hypoxia (27) and non-intrauterine-hypoxia (51) groups, and 45 healthy pregnant women were controls. The receiver operating characteristic (ROC) curve evaluated the diagnostic efficacy of each parameter for fetal intrauterine hypoxia. Relative to the controls and the non-intrauterine-hypoxia group, the umbilical artery (UA) S/D, PI, and RI, as well as the global work index (GWI), global effective work, and global ineffective work, increased in the PE group and intrauterine-hypoxia group (P < 0.05), respectively, while the cerebroplacental ratio (CPR) and global work efficiency decreased (P < 0.05). Relative to the controls group, the middle cerebral artery S/D, PI, and RI decreased in the PE group (P < 0.05). Correlation analysis showed that the fetoplacental circulation parameters were correlated with MW parameters (P < 0.05), and CPR achieved the highest correlation. ROC curves showed that UA-S/D, combined with GWI, produced the highest predictive value for fetal hypoxia in PE patients. There was a linear correlation between MW parameters and fetoplacental parameters, and CPR showed the highest correlation with MW. UA-S/D, combined with GWI, exhibited optimal diagnostic efficacy in predicting fetal intrauterine hypoxia in PE patients.

摘要

探讨子痫前期(PE)患者胎儿胎盘循环与母体左心室心肌做功(MW)参数之间的相关性以及胎儿缺氧的预测情况。将78例PE患者(PE组)分为宫内缺氧组(27例)和非宫内缺氧组(51例),并以45例健康孕妇作为对照组。采用受试者工作特征(ROC)曲线评估各参数对胎儿宫内缺氧的诊断效能。与对照组和非宫内缺氧组相比,PE组和宫内缺氧组的脐动脉(UA)收缩期与舒张期血流速度比值(S/D)、搏动指数(PI)和阻力指数(RI),以及整体做功指数(GWI)、整体有效做功和整体无效做功均升高(P<0.05),而脑胎盘率(CPR)和整体做功效率降低(P<0.05)。与对照组相比,PE组大脑中动脉S/D、PI和RI降低(P<0.05)。相关性分析显示,胎儿胎盘循环参数与MW参数相关(P<0.05),且CPR的相关性最高。ROC曲线显示,UA-S/D联合GWI对PE患者胎儿缺氧的预测价值最高。MW参数与胎儿胎盘参数之间存在线性相关性,且CPR与MW的相关性最高。UA-S/D联合GWI在预测PE患者胎儿宫内缺氧方面表现出最佳诊断效能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0da1/11682035/9a9a56c3d574/41598_2024_82545_Fig1_HTML.jpg

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