妊娠期高血压疾病孕妇胎儿脐血流变化检测及其临床意义

Detection of the Changes of Fetal Umbilical Blood Flow in Pregnant Women with Hypertensive Disorder Complicating Pregnancy and Its Clinical Significance

目的:分析妊娠期高血压疾病孕妇胎儿脐血流变化检测及其临床意义。方法:本研究为回顾性研究,将2017年1月-2020年12月笔者所在医院收治的98例妊娠期高血压疾病孕妇设为研究组,将同期于笔者所在医院进行产检的98例正常孕妇设为对照组。检测脐血流指标[脐动脉血流速度的收缩期峰值(S)与舒张期(D)的比值(S/D)、搏动指数(PI)及阻力指数(RI)]。比较两组胎儿脐血流指标。比较不同病情严重程度孕妇胎儿脐血流指标。分析胎儿脐血流指标与妊娠期高血压病情严重程度的相关性。比较不同妊娠结局患者脐血流指标。分析脐血流指标对妊娠期高血压疾病孕妇不良妊娠结局的预测价值。结果:研究组RI、PI、S/D均高于对照组,差异有统计学意义(P<0.05);重度组RI、PI、S/D均高于中度组及轻度组,且中度组高于轻度组,差异有统计学意义(P<0.05)。Kendall的tau-b(K)相关性检验显示,RI、PI、S/D与妊娠期高血压病情严重程度呈正相关(r>0,P<0.05);98例妊娠期高血压疾病孕妇,胎儿发生不良妊娠结局26例;不良妊娠结局组RI、PI、S/D均高于良好妊娠结局组,差异有统计学意义(P<0.05);ROC曲线显示,RI、PI、S/D预测妊娠期高血压疾病孕妇不良妊娠结局的AUC均>0.7,具有一定预测价值。结论:妊娠期高血压疾病孕妇胎儿脐血流变化与病情严重程度密切相关,在预测胎儿不良妊娠结局中具有一定价值,可为临床妊娠期高血压疾病孕妇病情评估及妊娠结局评估提供客观依据。

Objective:To analyze the changes of fetal umbilical blood flow in pregnant women with hypertensive disorder complicating pregnancy and its clinical significance.Method:This study was a retrospective study.A total of 98 pregnant women with hypertensive disorder complicating pregnancy admitted in our hospital from January 2017 to December 2020 were selected as the study group,and a total of 98 normal pregnant women who underwent obstetric examination in our hospital during the same period were selected as the control group.The umbilical blood flow indexes[the ratio of peak systolic(S)to diastolic(D)of umbilical artery blood flow velocity(S/D),pulse index(PI)and resistance index(RI)]were detected.Umbilical blood flow indexes was compared between the two groups.The umbilical blood flow indexes of pregnant women with different severity of disease were compared.The correlation between fetal umbilical blood flow indexes and the severity of hypertensive disorder complicating pregnancy was analyzed.The umbilical blood flow indexes of pregnant women with different pregnancy outcomes was analyzed.The predictive value of umbilical blood flow indexes on adverse pregnancy outcomes in pregnant women with hypertensive disorder complicating pregnancy was analyzed.Result:RI,PI and S/D in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).RI,PI and S/D in the severe group were higher than those in the moderate and mild groups,and the moderate group was higher than the mild group,and the differences were statistically significant(P<0.05).Kendall’s tau-b(K)correlation test showed that RI,PI and S/D were positively correlated with the severity of hypertensive disorder complicating pregnancy(r>0,P<0.05).Among 98 pregnant women with hypertensive disorder complicating pregnancy,26 cases had adverse pregnancy outcomes.RI,PI and S/D in the adverse pregnancy outcomes group were higher than those in the good pregnancy outcomes group,and the difference was statistically significant(P<0.05).ROC curve showed that the AUC of RI,PI and S/D in predicting adverse pregnancy outcomes of pregnant women with hypertensive disorder complicating pregnancy were all>0.7,showed a certain predictive value.Conclusion:The changes of fetal umbilical blood flow in pregnant women with hypertensive disorder complicating pregnancy are closely related to the severity of the disease,which has certain value in predicting the adverse pregnancy outcomes,and can provide objective basis for clinical evaluation of the condition and pregnancy outcomes of pregnant women with hypertensive disorder complicating pregnancy.