双胎妊娠孕妇血流动力学变化临床分析

Clinical Analysis of Hemodynamic Changes in Twin Pregnancy

目的:用无创血流动力学监测系统研究双胎妊娠孕妇的血流动力学特点,及其与妊娠并发症的关系。方法:选择双胎妊娠孕妇118例,分为双胎有并发症组(95例)和双胎无并发症组(23例),另选择同期正常单胎妊娠孕妇(90例)为对照(正常单胎妊娠组)。用无创血流动力学监测系统检测并比较3组孕妇的血流动力学参数:心率(HR)、平均动脉压(MAP)、心脏指数(CI)、心输出量(CO)、周围血管阻力指数(SVRI)和周围血管阻力(SVR)。结果:双胎无并发症组与正常单胎妊娠组比较,HR、CI、CO轻度增高,MAP、SVRI、SVR轻度降低,但差异均无统计学意义(P>0.05)。双胎有并发症组与另两组比较,CI、CO明显降低(P<0.05),MAP、SVRI、SVR明显升高(P<0.05)。结论:双胎妊娠孕妇发生妊娠期高血压、子痫前期、胎儿生长受限与孕妇心排出量降低、外周阻力升高有关。

Objective：To research on the maternal hemodynamic characteristic of twin pregnancy and de- tect the relationship between the hemodynamic alterations and pregnancy complications by using noninvasive hemodynamic monitoring system. Methods：118 twin pregnant women were classified into two groups：one with complicated pregnancy ,the other with uncomplicated pregnancy. The control group consisted of 90 nor- mally single pregnant women. Noninvasive hemodynamic monitoring system was employed to detect and compare maternal hemodynamic parameters in three groups, including HR, MAP, CI, CO, SVRI AND SVR. Results ：The heart rate （HR） and cardiac output （CI,CO） of uncomplicated twin pregnancies were slightly higher than those of normal single pregnancies,while the maternal mean arterial pressure （MAP） and pe- ripheral resistance（SVRI,SVR） of the former were slightly lower. But there were no significant differences statistically（ P 〉 0. 05）. Compared with the other two groups, the complicated twin pregnancies had clearly lower cardiac output （CI, CO） （P 〈 0.05） but remarkably higher MAP and peripheral resistance （SVRI, SVR） （ P 〈 0. 05）. Conclusions. Twin pregnancy complicated with gestation hypertension, preeclampsia or fetal growth restriction is associated with reduced maternal cardiac output and increased peripheral resist- ance.