Hütter W, Grab D, Schneider D, Terinde R, Wolf A
Frauenklinik, Kreiskrankenhaus Böblingen, Ulm, FRG.
Gynecol Obstet Invest. 1994;38(2):90-5. doi: 10.1159/000292456.
Continuous-wave Doppler sonography of uteroplacental vessels and the umbilical artery was used as an additive method in the management of risk pregnancies. Its major advantage lies in permitting noninvasive access to placental perfusion. In a sample of 650 singleton pregnancies considered at risk, flow patterns of the right and left uterine and arcuate arteries and of the umbilical artery were obtained. Increased resistance in uteroplacental circulation alone (90th percentile of resistance index and/or notching) was seen in 62 of 100 patients with confirmed growth retardation, proving the key role played by uteroplacental perfusion disorders. Early diastolic notching as well as incomplete vascular flow patterns were also found significantly more often in the growth-retarded group compared to the controls, especially in pregnancies additionally beset by hypertensive disorders. Doppler study of both utero- and fetoplacental circulation increased the sensitivity to 76% in pregnancies with intrauterine growth retardation, and to 90% in those cases with an additional risk of pregnancy-induced hypertension, while the false-positive rate (100-specificity) remained acceptable (17%).
子宫胎盘血管和脐动脉的连续波多普勒超声检查被用作高危妊娠管理中的一种辅助方法。其主要优势在于能够无创获取胎盘灌注情况。在650例被视为高危的单胎妊娠样本中，获取了左右子宫动脉、弓形动脉以及脐动脉的血流模式。在100例确诊为胎儿生长受限的患者中，有62例仅出现子宫胎盘循环阻力增加（阻力指数第90百分位数和/或切迹），这证明了子宫胎盘灌注障碍所起的关键作用。与对照组相比，生长受限组中早期舒张期切迹以及不完全血管血流模式的出现频率也显著更高，尤其是在合并高血压疾病的妊娠中。对子宫和胎儿胎盘循环进行多普勒研究后，对于胎儿生长受限的妊娠，敏感性提高到了76%；对于合并妊娠高血压额外风险的病例，敏感性提高到了90%，而假阳性率（100 - 特异性）仍可接受（17%）。
