子宫动脉血流参数对孕早期复发性流产患者妊娠结局的预测价值

Predictive Value of Uterine Artery Blood Flow Parameters in Early Pregnancy on Adverse Pregnancy Outcomes in Patients with Recurrent Spontaneous Abortion

目的:探讨复发性流产(recurrent spontaneous abortion,RSA)患者子宫动脉超声参数对妊娠结局的预测价值。方法:选取2016年8月至2019年8月我院收治的100例孕期6~10周的RSA患者为观察组,同期120例孕期6~10周正常孕妇为对照组。对两组孕妇进行子宫动脉多普勒超声血流成像检查,比较两组子宫动脉的动脉搏动指数(PI)、阻力指数(RI)、收缩压最大血流速度/舒张末期最大血流速度(S/D),利用接收者操作特征(ROC)曲线评价超声参数对不良妊娠结局的诊断价值,Logstic回归分析超声参数与不良妊娠结局的关系。结果:RSA组PI、RI、S/D均高于对照组,差异有统计学意义(P<0.05)。PI、RI、S/D、PI+RI、PI+S/D、RI+S/D及PI+RI+S/D对不良妊娠结局预测均有较高的灵敏度和特异度,曲线下面积(AUC)分别为0.638,0.801,0.816,0.832,0.827,0.881,0.962。PI、RI、S/D增高为不良妊娠的高危因素(P<0.05)。结论:与正常孕妇相比,孕早期RSA患者子宫动脉多普勒超声血流指标升高,对不良妊娠具有较高的预测价值。

Objective:To investigate the predictive value of ultrasound parameters of uterine artery in patients with recurrent spontaneous abortion(RSA)for pregnancy outcomes.Methods:100 RSA patients with 6~10 weeks of pregnancy in our hospital from August 2016 to August 2019 were selected as the observation group,and 120 cases of normal pregnant women with 6~10 weeks of pregnancy were selected as the control group.The uterine artery hemodynamic parameters(PI,RI,S/D)of pregnant women were monitored by Doppler ultrasound.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of ultrasound parameters for adverse pregnancy outcomes.The relationship between ultrasound parameters and adverse pregnancy outcomes was analyzed by logistic regression.Results:The PI,RI and S/D value in RSA group were higher than those of control group(P<0.05).PI,RI,S/D,PI+RI,PI+S/D,RI+S/D and PI+RI+S/D had high sensitivity and specificity in predicting adverse pregnancy outcomes.The area under the curve(AUC)was 0.638,0.801,0.816,0.832,0.827,0.881 and 0.962,respectively.PI,RI and S/D were high risk factors of adverse pregnancy(P<0.05).Conclusion:Compared with normal pregnant women,uterine artery Doppler ultrasound blood flow index of RSA patients in early pregnancy is higher,which has higher predictive value for adverse pregnancy.