孕中期多普勒超声测量子宫动脉血流对自发性早产的预测价值

Predictive Value of Uterine Artery Blood Flow Measured by Mid-pregnancy Doppler Ultrasound for Spontaneous Preterm Labor

目的:探讨孕中期多普勒超声测量子宫动脉血流参数对孕妇自发性早产的预测价值。方法:回顾性分析2022年12月—2023年5月于百色市人民医院分娩的74例自发性早产孕妇(早产组),以及同期55例足月分娩孕妇(足月产组)的临床资料。两组均接受多普勒超声测量,比较两组收缩期峰值流速、阻力指数(RI)、搏动指数、脐动脉收缩期峰值流速/舒张期流速,分析其中差异有统计学意义的数值对自发性早产的预测价值。结果:两组收缩期峰值流速、搏动指数、脐动脉收缩期峰值流速/舒张期流速比较,差异无统计学意义(P>0.05);早产组RI高于足月产组,差异有统计学意义(P=0.033)。受试者工作特征曲线显示,RI诊断自发性早产的曲线下面积为0.610,预测价值中等,对应截断值为0.545,灵敏度为67.6%,特异度为58.2%(P=0.033)。结论:多普勒超声测量子宫动脉RI值对预测自发性早产具有一定价值,但仍需要结合其他指标或临床症状等进行判断。

Objective:To investigate the predictive value of uterine artery blood flow parameters measured by mid-pregnancy Doppler ultrasound for spontaneous preterm labor in pregnant women.Methods:The clinical data of seventy-four pregnant women with spontaneous preterm labor(preterm labor group)who were delivered in Baise People's Hospital from December 2022 to May 2023 and fifty-five pregnant women who were delivered at full-term during the same period(full-term labor group)were retrospectively analyzed.Both groups received Doppler ultrasound measurements,and peak systolic flow rate,resistance index(RI),beat-to-beat index,and umbilical artery peak systolic flow rate/diastolic flow rate were compared between the two groups,analyzed the predictive value of the statistically significant differences in spontaneous preterm delivery.Results:Comparison of peak systolic flow rate,pulsatility index,and umbilical artery peak systolic flow rate/diastolic flow rate between the two groups showed that the differences were not statistically significant(P>0.05);RI in the preterm labor group was higher than that in the full-term labor group,and the difference was statistically significant(P=0.033).The receiver operating characteristic curve showed that the area under the curve of RI for the diagnosis of spontaneous preterm labor was 0.610,which had a moderate predictive value and corresponded to a cut-off value of 0.545,with a sensitivity of 67.6%and a specificity of 58.2%(P=0.033).Conclusion:Doppler ultrasound measurement of uterine artery RI value is valuable in predicting spontaneous preterm labor,but still needs to be judged in combination with other indicators or clinical symptoms.