妊娠早期低风险人群子宫动脉多普勒搏动指数与不良妊娠结局的关系

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Abstract Objective To discuss the feasibility of uterine artery pulsatility indexes (UtA-PI) 11-13+6 weeks in predicting adverse pregnancy outcomes. Methods From January 1, 2017 to June 31, 2567 singleton pregnancies presented for routine prenatal care in Shanghai Changning Maternity & Infant Health Hospital, who were recruited as the research object. Doppler blood flow waveforms of bilateral uterine arteries of each pregnant woman were detected at 11-13+6 weeks of gestation were measured, the UtA-PI and resistance indexes (UtA-RI), and the presence or absence of early diastolic notching were recorded. The maternal and neonatal outcomes were followed up. Results Among all the 2567 cases, 55 cases were excluded because of termination for fetal abnormalities or fetal death before 28 weeks of gestation, the other 2512 cases were enrolled in this analysis. Among the 2512 cases enrolled, there were 359 cases (14.29%) of adverse outcomes, including, 99 cases of hypertensive disorder complicating pregnancies, 88 cases of preeclampsia, 76 cases of fetal growth restriction, 76 cases of small for gestational age, 11 cases of placental abruption, 9 cases of stillbirth; and the remaining 2153 cases had normal outcomes. The mean value and the 90th percentile of UtA-PI were higher in the adverse outcome group (1.8, 2.4) than that in normal outcome group (1.68, 2.19), the differences were statistically significant (P < 0.05), respectively. By using the 90th percentile of UtA-PI as cut-off value, the sensitivity was 71% and the specificity was 75% in predicting severe adverse pregnancy outcomes, but the sensitivity was low (27%) and the specificity was high (89%) in predicting any kind of adverse pregnancy outcomes, and the sensitivity (19%) was the lowest while the specificity was high (91%) in predicting fetal growth restriction. By using the 90th percentile of UtA-PI as cut-off value, the negative predicting values were high in all groups in predicting each kind of adverse pregnancy outcomes. Conclusion UtA-PI at 11-13+6 weeks of gestation shows significance in predicting the development of adverse outcomes in low-risk pregnancies, but provides a low sensitivity.

Key words： Doppler Uterine artery Pre-eclampsia Fetal growth restriction Placental abruption First trimester

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	HE Biyuan ZHOU Yuqing▲

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HE Biyuan ZHOU Yuqing▲. Association of first-trimester uterine artery pulsatility index with adverse outcomes in low-risk pregnancies[J]. 中国医药导报, 2019, 16(17): 72-75.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I17/72

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