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早孕期子宫动脉血流参数与复发性流产的相关性
谷嫦娟,王晓云,晁岚
0
(山东大学齐鲁医院妇产科;东营胜利医院妇产科)
摘要:
【摘要】 目的 探讨早孕期子宫动脉血流参数变化与复发性流产的关系及对妊娠结局的影响。 方法 回顾性选择流产次数≥3次且孕期6~10周的90例孕妇为观察组,再选择无不良妊娠史的孕妇90例为对照组,分别在排卵后、孕6~10周内以阴道超声对孕妇的双侧子宫动脉血流动力学参数(搏动指数PI、阻力指数RI、动脉收缩末期峰值/舒张末期流速S/D)进行监测,比较两组各项血流参数变化和对妊娠结局的影响。 结果 观察组孕妇子宫动脉血流参数PI、RI、S/D均明显高于对照组,组间比较差异均有统计学意义(P<0.05);观察组早期流产率(75.56%)显著高于对照组(3.33%),两组比较差异有统计学意义(P=0.01)。受试者ROC曲线表明子宫动脉血流参数RI、PI、S/D对妊娠结局都有良好的诊断价值,其中PI的曲线下面积最大,但三者在敏感性、特异性等方面比较差异无统计学意义(P>0.05)。进行Logstic回归分析,S/D、RI及PI增高为复发性流产的高危因素(P<0.05)。 结论 复发性流产孕妇孕早期子宫动脉血流参数存在异常,PI、RI、S/D指数越大,流产率越高。
关键词:  孕早期  彩色多普勒检查  子宫动脉血流参数  复发性流产  妊娠结局
DOI:
基金项目:
Correlation between uterine artery blood flow parameters and recurrent spontaneous abortion in early pregnancy
GU Changjuan,WANG Xiaoyun,CHAO Lan
(Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University;Department of Obstetrics and Gynecology, Dongying Shengli Hospital)
Abstract:
【Abstract】 Objective The parameters of uterine artery blood flow in early pregnancy were observed and analyzed, and the relationship between the parameter changes and recurrent abortion and the effect on pregnancy outcome were discussed. Methods 90 pregnant women with abortion times ≥ 3 times and 6 to 10 weeks gestation were selected as observation group, and 90 pregnant women without history of adverse pregnancy were selected as control group. The bilateral uterine artery hemodynamic parameters (beating index PI, resistance index RI, arterial endsystolic peak/enddiastolic flow rate S/D) of pregnant women were monitored by vaginal ultrasound after ovulation and 6 to 10 weeks of pregnancy, respectively. The changes in blood flow parameters and the effects on pregnancy outcomes were compared between the two groups. Results The parameters of uterine artery blood flow PI, RI, S/D in the observation group were significantly higher than those in the control group, and the comparison between groups (Statistics=5477, 8.828, 8.584, P<005), all had statistical significance. The early abortion rate of the observation group was 7556%, which was significantly higher than that of the control group (3.33%, 2=15.050, P<0.05). The ROC curve of the subjects showed that the uterine artery blood flow parameters RI, PI, S/D had good diagnostic value for pregnancy outcomes, and the area under the curve of PI was the largest, but the differences in sensitivity and specificity were compared. Not statistically significant (P>0.05). Logistic regression analysis showed that S/D, RI, and PI increased to high risk factors for recurrent spontaneous abortion (95% CI: 2.069-16.786, 1.255-5.114, 2.710-6.346; P<0.05). Conclusion There are abnormalities in uterine artery blood flow parameters in pregnant women with recurrent spontaneous abortion. The higher the PI, RI, S/D index, the higher the abortion rate, and the early and effective correction of abnormal blood flow in early stage, it plays a good role in pregnancy outcome.
Key words:  Early pregnancy  Color Doppler examination  Uterine artery blood flow parameters  Habitual abortion  Pregnancy outcome

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