孕中期彩超检测子宫动脉血流对预测妊娠期高血压疾病的价值

Value of color Doppler ultrasound in detecting uterine artery blood flow to monitor the development of hypertensive disorder complicating pregnancy in the second trimester

目的探讨妊娠期高血压疾病(HDCP)在孕妇孕中期子宫动脉多普勒血流参数检测的临床价值。方法采用回顾性研究,选取2019年10月~2021年1月在潍坊市中医院东院区产检的198例单胎孕妇,所有孕妇随访至住院分娩,其中正常妊娠组100例,HDCP组患者98例(进一步分为妊娠期高血压50例,子痫前期组48例)。所有孕妇在孕中期21^(+6)~25^(+6)周行彩色多普勒超声系统筛查,检测双侧子宫动脉血流参数(包括搏动指数PI、阻力指数RI、收缩末期峰值流速/舒张末期峰值流速S/D),并取双侧平均值。比较两组孕妇子宫动脉的血流参数,分娩方式,分娩孕周及新生儿出生体重,1min Apgar评分情况。结果HDCP组孕妇子宫动脉血流参数值均高于正常组,差异均有统计学意义,且进一步研究发现子痫前期组血流参数值显著高于妊娠期高血压组;HDCP组剖宫产率,早产率,新生儿窒息情况均明显高于正常妊娠组。结论彩超多普勒超声能检测HDCP孕妇子宫血流变化,妊娠中期检测子宫动脉血流参数能够对预测HDCP的发生及预测母儿结局有一定的临床价值。

Objective To explore the clinical value of uterine artery Doppler parameters in the second trimester of pregnancy of hypertensive disorder complicating pregnancy(HDCP).Methods One hundred and ninty-eight women were selected from all the patients delivery in Weifang Traditional Chinese Hospital from October 2019 to January 2021,who were divided into HDCP group(stratified into gestational hypertensive group and pre-eclampsia group)and the control group.Uterine artery Doppler was obtained from 21^(+6) to 25^(+6) weeks and the blood flow parameters of bilateral uterine arteries(including PI,RI,S/D)were detected.the bilateral mean value was calculated.And the relationship of maternal and fetal outcomes and delivery condition were compared were recorded between two groups.Results Compared with control group,blood flow parameters(PI,RI,S/D)were significantly higher in HDCP group.The differences achieved statistic significance.Further studies found that blood flow parameters in pre-eclampsia group were significantly higher than that in gestational hypertensive group.Cesarean section rate,premature delivery rate,low-birth weight rate were significantly parameters in the HDCP group.Conclusion The ultrasonography Doppler can monitor uterine artery resistance,and these value in the second trimester can predict the development of hypertensive disorder complicating pregnant and severe abnormal perinatal outcomes.