早孕前、后子宫动脉血流与妊娠结局的相关性研究

Relevance on the correlation of pregnant outcome and uterine artery flow in before and after early pregnancy

目的通过对育龄期正常及复发性流产(RSA)妇女备孕前1个月及孕后10周内子宫动脉血流(UtA)动力学系统相关指标的观察,了解月经周期的黄体期及孕10周内UtA动力学特点及其对妊娠结局的影响。方法将既往无不良妊娠史的育龄期妇女250例及既往有3次及以上自然流产的史妇女168例纳入研究,采用阴道超声于排卵后及孕10周内监测研究对象双侧子宫动脉血流动力学参数,测量参数包括搏动指数(PI)、阻力指数(RI)、收缩期峰值流速/舒张末期流速(S/D);记录各组的PI、RI、S/D值,统计分析各组子宫动脉PI、RI、S/D值的差异,比较妊娠丢失率的不同。结果孕前后或孕后子宫动脉血流异常者与正常者相比较,妊娠丢失率有统计学差异(P<0.05)。孕前后或孕后子宫动脉血流值异常未治疗者与治疗后孕10周内恢复正常者比较,PI、RI、S/D及妊娠丢失率均有统计学差异(P<0.05)。RSA患者孕前异常血流经治疗后,孕后子宫动脉血流异常率降低、异常血流治疗恢复率升高,与孕前未纠正者相比较,有统计学差异(P<0.05)。结论孕早期子宫动脉血流参数与妊娠结局有相关性。异常血流早期纠正,能显著改善妊娠结局。RSA患者孕前子宫动脉血流参数影响妊娠结局。

Objective To identify the relationship between uterine artery blood flow and pregnancy outcome, and to comprehend the uterine artery blood flow velocity characteristics of luteal phase of the menstrual cycle and pregnancy 10 weeks. Methods 250 subjects with no previous history of adverse pregnancy and 168 subjects with more than three times of spontaneous abortion were included. Monitored the bilateral uterine artery blood flow velocity parameters, which included pulsatility index （PI）, resistance index （RI）, and peak systolic velocity/diastolic velocity （S/D）, using transvaginal ultrasound at 10 weeks of pregnancy and after ovulation. The values of PI, RI, and S/D were recorded. Results Pregnancy loss rates had significant difference between subjects of abnormal uterine artery blood flow and normal controls （P〈0.05）;PI, RI, and S/D values and pregnancy loss rate were all significantly different between subjects of abnormal uterine artery blood flow with systematic treatment after pregnancy and without treatment;The rate of abnormal uterine artery blood flow was decreased and the treatment recovery rate of uterine artery blood flow was increased after treatment. Conclusions Uterine artery blood flow parameters of trimester correlated with pregnancy outcomes;Treating abnormal blood flow earlier can significantly improve pregnancy outcomes; Pre-pregnancy uterine artery blood flow parameters of recurrent abortion can affect pregnancy outcomes.