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妊娠期高血压孕妇胎儿健康状况与脐动脉多普勒参数的相关性

The Correlation Between Fetal Wellbeing and Umbilical Doppler Parameters in Pregnant Women with Gestational Hypertension.

作者信息

Lin Hualan, Shen Meifang, Li Dongbei, Sun Qiuxia, Lan Liubing

机构信息

Obstetrical Department, Meizhou people's Hospital, Meizhou City, Guangdong Province, 514000, People's Republic of China.

出版信息

Int J Womens Health. 2025 Apr 9;17:1009-1018. doi: 10.2147/IJWH.S514427. eCollection 2025.

Abstract

OBJECTIVE

To investigate the role of umbilical cord blood flow parameters in evaluating intrauterine fetal hypoxia and fetal growth restriction in pregnant women with gestational hypertension.

METHODS

One hundred and nine patients with gestational hypertension admitted from January 2020 to December 2023 were enrolled in this study. The peak systolic velocity/end diastolic velocity (S/D), pulse index (PI) and resistance index (RI) of cord blood were measured by ultrasound. According to the S/D, 109 cases were divided into 62 cases in the control group (S/D < 3) and 47 cases in the observation group (S/D ≥ 3), and the prognosis of pregnant women and fetuses in the two groups were compared. The ROC curves were used to analyze the effects of different parameters of umbilical blood flow on intrauterine fetal hypoxia and fetal growth restriction in pregnant women with gestational hypertension.

RESULTS

The incidence of intrauterine fetal hypoxia, fetal growth restriction, cesarean section, and unresponsive type of non-irritation test was decreased in the control group compared with the observation group ( < 0.05). However, there was no statistical difference in the incidence of neonatal asphyxia between the two groups (P > 0.05). ROC curve analysis showed that cord blood flow RI of pregnant women with gestational hypertension had the highest sensitivity and AUC in predicting intrauterine fetal hypoxia and growth restriction, and PI had the highest specificity in predicting intrauterine fetal growth restriction. The specificity of S/D, PI and RI in predicting intrauterine hypoxia was consistent (all 80%).

CONCLUSION

The different parameters of umbilical blood flow in hypertensive pregnant women during pregnancy provide a good assessment of intrauterine fetal condition and can be used as clinical indicators to predict poor prognosis of intrauterine fetal hypoxia and fetal growth restriction.

摘要

目的

探讨脐血流参数在评估妊娠期高血压孕妇宫内胎儿缺氧及胎儿生长受限中的作用。

方法

选取2020年1月至2023年12月收治的109例妊娠期高血压患者纳入本研究。采用超声测量脐血的收缩期峰值流速/舒张末期流速(S/D)、搏动指数(PI)及阻力指数(RI)。根据S/D将109例患者分为对照组62例(S/D<3)和观察组47例(S/D≥3),比较两组孕妇及胎儿的预后情况。采用ROC曲线分析脐血流不同参数对妊娠期高血压孕妇宫内胎儿缺氧及胎儿生长受限的影响。

结果

与观察组相比,对照组宫内胎儿缺氧、胎儿生长受限、剖宫产及无应激试验无反应型的发生率降低(<0.05)。然而,两组新生儿窒息发生率差异无统计学意义(P>0.05)。ROC曲线分析显示,妊娠期高血压孕妇脐血流RI在预测宫内胎儿缺氧及生长受限时敏感性及AUC最高,PI在预测宫内胎儿生长受限时特异性最高。S/D、PI及RI预测宫内缺氧的特异性一致(均为80%)。

结论

妊娠期高血压孕妇孕期脐血流不同参数可较好地评估宫内胎儿状况,可作为预测宫内胎儿缺氧及胎儿生长受限不良预后的临床指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4137/11994114/c017597e2fad/IJWH-17-1009-g0001.jpg

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