子宫动脉多普勒在妊娠高血压孕妇与妊娠不良结局关系中的应用价值

Application of uterine artery doppler in the evaluation of adverse perinatal outcome in women with hypertensive disorder complicating pregnancies

目的评价妊娠期高血压疾病中子宫动脉多普勒在妊娠不良结局的应用价值。方法定群分析妊娠期高血压疾病100例,并随访至产后,比较子宫动脉多普勒异常组与正常组间的分娩周数,新生儿体重、早产、胎儿生长受限(FGR)等妊娠结局有无差异;以妊娠不良结局(FGR和或者早产<34周)为因变量,以子宫动脉多普勒、高血压及蛋白尿为自变量进行多因素Logistic回归分析。结果子宫动脉多普勒异常组间的分娩周数、新生儿体重小于正常组,早产、胎儿生长受限发生率高于正常组;多因素回归分析显示子宫动脉多普勒是唯一能够预测妊娠不良结局的指标,OR值为10.84(P<0.000 1)。结论子宫动脉多普勒异常是预测妊娠不良结局的有效指标,妊娠期高血压疾病患者产前行子宫动脉超声多普勒检查可评估其妊娠结局。

Objective To evaluate the value of uterine artery Doppler in evaluating adverse perinatal outcome in women with hypertensive disorder complicating pregnancies.Methods A cohort study were performed in 100 patients with hypertensive disorder complicating pregnancies.All the cases were followed up until postpartum.The weeks of gestation,birth weight,premature birth,fetal growth restriction（FGR） were compared between the abnormal and normal uterine artery Doppler groups.Logistic regression model analysis was carried out,taking FGR and/or Delivery34 weeks as the dependent variable and uterine artery Doppler,hypertension,proteinuria as the independent variables.Results Significantly earlier delivery,lower birth weight,and higher number of premature birth and FGR fetuses were found in abnormal uterine artery Doppler group,compared with that in the normal uterine artery Doppler group.Multivariate regression analysis showed that uterine artery Doppler was the only parameter that significantly predicted pregnancy outcome with an OR of 10.84（P〈0.000 1）.Conclusion Abnormal uterine Doppler was effective index for predicting adverse perinatal outcome,which serves as a useful surveillance test in assessing pregnancy outcome for women with hypertensive disorder complicating pregnancies.