异常脐动脉波形：子痫前期患者围产期不良结局的有力且独立预测指标。
An abnormal umbilical artery waveform: a strong and independent predictor of adverse perinatal outcome in patients with preeclampsia.
作者信息
Yoon B H, Lee C M, Kim S W
机构信息
Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Korea.
出版信息
Am J Obstet Gynecol. 1994 Sep;171(3):713-21. doi: 10.1016/0002-9378(94)90087-6.
OBJECTIVE
An abnormal umbilical artery Doppler waveform is a risk factor for adverse perinatal outcome. However, it has not been established whether this is related to the earlier gestational age at delivery of fetuses with abnormal Doppler findings or whether Doppler findings are an independent predictor of perinatal outcome. Our purpose was to determine whether an abnormal Doppler umbilical artery waveform is associated with adverse perinatal outcome even after the gestational age at delivery is controlled for as a confounding variable in patients with preeclampsia.
STUDY DESIGN
Umbilical artery velocimetry studies were performed within 7 days of delivery in 72 consecutive patients admitted to our unit with preeclampsia. Adverse perinatal outcome was defined as fetal distress requiring cesarean delivery. Apgar score < 7 at 5 minutes, significant neonatal morbidity, or perinatal death. Significant neonatal morbidity was defined as neonatal sepsis, intraventricular hemorrhage (grade > or = 2), respiratory distress syndrome, pneumonia, bronchopulmonary dysplasia, acute renal failure, or necrotizing enterocolitis. Stepwise multiple logistic regression and receiver-operator characteristic curve analysis were used.
RESULTS
Patients with abnormal umbilical artery velocimetry had a significantly higher rate of complications, including cesarean section for fetal distress, preterm delivery, low Apgar scores, significant neonatal morbidity, and perinatal death, than did patients with a normal waveform. Receiver-operator characteristic curve and stepwise logistic regression analysis indicated that an abnormal umbilical artery waveform was a significant independent predictor for the development of adverse perinatal outcome (odds ratio 14.2, p < 0.005) after other confounding variables were adjusted.
CONCLUSION
An abnormal Doppler umbilical artery waveform is a strong and independent predictor of adverse perinatal outcome in patients with preeclampsia.
目的
脐动脉多普勒波形异常是围产期不良结局的一个危险因素。然而，目前尚未明确这是否与多普勒检查结果异常的胎儿更早的分娩孕周有关，或者多普勒检查结果是否是围产期结局的独立预测指标。我们的目的是确定在子痫前期患者中，即使将分娩孕周作为混杂变量进行控制后，脐动脉多普勒波形异常是否仍与围产期不良结局相关。
研究设计
对我院收治的72例连续子痫前期患者在分娩后7天内进行脐动脉血流速度测定研究。围产期不良结局定义为因胎儿窘迫而行剖宫产、5分钟时阿氏评分<7分、显著的新生儿发病率或围产期死亡。显著的新生儿发病率定义为新生儿败血症、脑室内出血（≥2级）、呼吸窘迫综合征、肺炎、支气管肺发育不良、急性肾衰竭或坏死性小肠结肠炎。采用逐步多因素logistic回归分析和受试者工作特征曲线分析。
结果
脐动脉血流速度测定异常的患者，其并发症发生率显著高于波形正常的患者，包括因胎儿窘迫行剖宫产、早产、低阿氏评分、显著的新生儿发病率和围产期死亡。受试者工作特征曲线和逐步logistic回归分析表明，在调整其他混杂变量后，脐动脉波形异常是围产期不良结局发生的显著独立预测指标（优势比14.2,P<0.005）。
结论
脐动脉多普勒波形异常是子痫前期患者围产期不良结局的一个强有力的独立预测指标。
Zotero 插件