早期先兆流产子宫螺旋动脉血流动力学对妊娠结局的预测价值

Predictive Value of Uterine Spiral Artery Hemodynamics for Assessing Pregnant Outcome in Early Pregnant Patients with Threatened Abortion

目的:探讨早期先兆流产患者子宫螺旋动脉的血流动力学变化及与妊娠结局的关系。方法:选择先兆流产患者157例,按临床妊娠结局分3组:维持妊娠组(89例)、不能维持妊娠组(45例)和空孕囊组(23例),109例正常宫内早孕为对照组。经阴道彩色多普勒超声测定子宫螺旋动脉收缩期峰值血流(PSV)、舒张期末流速(EDV)和阻力指数(RI)。结果:各组患者间年龄、孕囊平均径、停经时间比较无明显差异(P>0.05)。能维持妊娠组PSV、EDV、RI与对照组比较,差异无统计学意义(P>0.05);不能维持妊娠组PSV、EDV、RI与能维持妊娠组及对照组比较有统计学意义(P<0.05,P<0.01),表现为EDV显著性降低,RI值显著性升高;空孕囊组PSV、EDV高于对照组,RI低于对照组,差异有统计学意义(P<0.05)。结论:经阴道彩色多普勒超声测定早孕子宫螺旋动脉PSV、EDV、RI对判断先兆流产预后有临床参考价值。

Objective To investigate the hemodynamics changes of uterine spiral artery in patients with early threatened abortion and to explore its relationship with the pregnant outcome by transvaginal color Doppler ultrasound.Methods Total 157 patients with threatened abortion were selected and divided into maintainable pregnancy group(89 case),inmaintainable pregnancy group(45 case) and empty embryo sac group(23 case) according to different outcomes,109 cases of normal early pregnancy women were selected as control group.The peak systolic(PSV),end diasotolic(EDV) and resistance index(RI) of uterine spiral artary were detected by transvaginal color Doppler ultrasound.Results There were no significant difference in age,average diameter of gestational sac and menelipsis time among every group(P>0.05).Compared with maintainable pregnancy group and inmaintainable pregnancy group,PSV,EDV were decresed and RI was increased significantly in inmaintainable pregnancy group(P<0.05).The PSV and EDV of inmaintainable pregnancy group were lower than that of control group,RI was higher than that of control group.The difference between them was statistically significant(P<0.01);A comparison maintainable pregnancy group and the control group,the difference among them was not statistically significant(P>0.05);PSV and EDV of empty embryo sac group measured values were highest in four groups,RI was lower than the control group,significantly(P<0.05).Conclusion The hemodynamics index of uterine spiral artery PSV,EDV and RI may play important roles in prediction of threatened abortion in early pregnancy.