引用本文:张 瑛.妊娠早期双侧子宫动脉血流参数和舒张早期切迹评估复发性流产孕妇不良妊娠结局的效能分析[J].中国临床新医学,2022,15(9):858-861.
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妊娠早期双侧子宫动脉血流参数和舒张早期切迹评估复发性流产孕妇不良妊娠结局的效能分析
张 瑛
351100 福建,莆田市妇幼保健院超声科
摘要:
[摘要] 目的 探讨妊娠早期双侧子宫动脉血流参数和舒张早期切迹评估复发性流产孕妇发生不良妊娠结局的效能。方法 选择2020年8月至2021年8月莆田市妇幼保健院收治的复发性流产者40例为观察组,另选择同期正常妊娠者40名为对照组。均使用Voluson 730 Pro彩色多普勒超声诊断仪进行检查,获取双侧子宫动脉血流参数[双侧子宫动脉收缩期峰值流速/舒张末期流速(S/D)值、子宫动脉搏动指数(PI)值、子宫动脉阻力指数(RI)值],并观察舒张早期切迹的出现情况。比较两组双侧子宫动脉血流参数水平和舒张早期切迹发生率。分析舒张早期切迹与不良妊娠结局的关联性。采用ROC曲线法评估双侧子宫动脉血流参数预测复发性流产孕妇发生不良妊娠结局的效能。结果 观察组S/D值、PI值和RI值均高于对照组,差异有统计学意义(P<0.05),出现舒张早期切迹的人数比例大于对照组(90.00% vs 10.00%; χ2=48.050,P=0.000)。出现舒张早期切迹者的妊娠期高血压、妊娠期糖尿病、子痫和早产发生率均显著高于无舒张早期切迹者,差异有统计学意义(P<0.05)。ROC分析结果显示,S/D值、PI值和RI值均具有预测复发性流产孕妇发生不良妊娠结局的价值(P<0.05),其中以PI值效能最高[AUC(95%CI)=0.697(0.570~0.824),P=0.013]。结论 针对复发性流产孕妇进行双侧子宫动脉血流参数和舒张早期切迹检测,可评估不良妊娠结局的发生,有利于指导临床治疗。
关键词:  妊娠早期  舒张早期切迹  双侧子宫动脉血流参数  复发性流产
DOI:10.3969/j.issn.1674-3806.2022.09.17
分类号:R 445.1
基金项目:
Analysis on the efficiency of bilateral uterine artery blood flow parameters and early diastolic notch in assessing adverse pregnancy outcomes in pregnant women with recurrent miscarriage in early pregnancy
ZHANG Ying
Department of Ultrasound, Putian Maternal and Child Health Hospital, Fujian 351100, China
Abstract:
[Abstract] Objective To investigate the efficiency of bilateral uterine artery blood flow parameters and early diastolic notch in assessing adverse pregnancy outcomes in pregnant women with recurrent miscarriage in early pregnancy. Methods Forty cases of recurrent miscarriage admitted to Putian Maternal and Child Health Hospital from August 2020 to August 2021 were selected as the observation group, and 40 cases of normal pregnancy during the same period were selected as the control group. All the patients were examined with Voluson 730 Pro color Doppler ultrasound diagnostic instrument to obtain bilateral uterine artery blood flow parameters[bilateral uterine artery peak systolic velocity/end diastolic velocity(S/D) value, uterine artery pulse index(PI) value and uterine artery resistance index(RI) value], and the occurrence of early diastolic notch was observed. The levels of bilateral uterine artery blood flow parameters and the incidence of early diastolic notch were compared between the two groups. The correlation between early diastolic notch and adverse pregnancy outcomes was analyzed. The receiver operator characteristic(ROC) curve method was used to assess the efficiency of bilateral uterine artery blood flow parameters in predicting adverse pregnancy outcomes in pregnant women with recurrent miscarriage. Results The S/D value, PI value and RI value of the observation group were higher than those of the control group, and the differences were statistically significant(P<0.05). The proportion of the patients with early diastolic notch in the observation group was larger than that in the control group(90.00% vs 10.00%; χ2=48.050, P=0.000). The incidence rates of gestational hypertension, gestational diabetes mellitus, eclampsia and preterm birth in the patients with early diastolic notch were significantly higher than those without early diastolic notch, and the differences were statistically significant(P<0.05). The results of ROC curve analysis showed that the S/D value, PI value and RI value all had the predictive value of adverse pregnancy outcomes in pregnant women with recurrent miscarriage(P<0.05), and the PI value had the highest efficiency[AUC(95%CI)=0.697(0.570-0.824), P=0.013]. Conclusion The detection of bilateral uterine artery blood flow parameters and early diastolic notch in pregnant women with recurrent miscarriage can assess the occurrence of adverse pregnancy outcomes and help to guide clinical treatment.
Key words:  Early pregnancy  Early diastolic notch  Bilateral uterine artery blood flow parameters  Recurrent miscarriage