妊娠早期胎盘绒毛区优势血流与早期自然流产的相关性  

Correlation between the Predominant Blood Flow in the Chorionic Villi and Early Spontaneous Abortion

作　　者：张伊 王洪[2] 张志坤[3] 张骐 谢擎 王昕妍 张印峰[4] ZHANG Yi;WANG Hong;ZHANG Zhi-kun;ZHANG Qi;XIE Qing;WANG Xin-yan;ZHANG Yin-feng(Chengde Medical College,Chengde 067000,Hebei Province,China;Department of Ultrasound,Chengde Central Hospital,Chengde 067000,Hebei Province,China;Department of Ultrasound,Tianjin Central Hospital of Gynecology Obstetrics,Tianjin 300100,China;Center for Reproductive Medicine,Tianjin Central Hospital of Gynecology Obstetrics,Tianjin 300100,China)

机构地区：[1]承德医学院,067000 [2]承德市中心医院超声科 [3]天津市中心妇产科医院超声科 [4]天津市中心妇产科医院生殖医学中心

出　　处：《国际生殖健康／计划生育杂志》2022年第2期94-100,共7页Journal of International Reproductive Health/Family Planning

摘　　要：目的:使用超声HD-Flow模式观察并验证妊娠早期绒毛区优势血流的存在及变化,并探索其与早期自然流产的关系。方法:对接受体外受精-胚胎移植后成功获得单胎妊娠的女性分别于孕5周、孕7周和孕12~13周行超声检查,测量绒毛区优势血流信号及孕囊、卵黄囊、胎芽和胎心等指标,分析绒毛区优势血流信号随孕龄变化情况;分析该信号长度与早期自然流产的关系。结果:在接受体外受精-胚胎移植获得妊娠的女性中证实了绒毛区优势血流的存在,该血流信号长度随孕龄增加而增长,优势血流静脉流速和下方蜕膜区螺旋动脉流速随孕龄增加而增长,螺旋动脉阻力指数随孕龄增加而下降;孕5周和孕7周持续妊娠组优势血流信号检出率及长度均显著高于早期自然流产组(P<0.05)。孕7周时,优势血流信号长度<第5百分位数者发生早期自然流产的风险是≥第5百分位数者的10.84倍(OR=10.84,95%CI:6.12~19.22,P<0.001)。结论:妊娠早期胎盘绒毛区存在优势血流信号,其长度过短可能提示早期自然流产风险增加。Objective:To observe the predominant blood flow in the chorionic villi during early pregnancy using ultrasound HD-Flow modality,and to explore the relationship between its changes and early spontaneous abortion.Methods:In women with singleton pregnancy after in vitro fertilization-embryo transfer(IVF-ET),ultrasound examinations were performed at 5,7 and 12-13 weeks of gestation to measure the predominant flow signal in the chorionic villi and indicators of the gestational sac,yolk sac,embryo and fetal heartbeat.The changes of the predominant flow signal in the chorionic villi with the gestational age,and the related factors,were analysed.The relationship between the flow signal length and the risk of early miscarriage were analyzed.Results:The presence of the predominant flow in the chorionic villi was confirmed in women who underwent IVF-ET,and the length of flow signal was increased with the increasing gestational age.The detection rate and length of this flow signal were significantly higher in the sustained pregnancy group than those in the early spontaneous abortion group(P<0.001).At 7 weeks of gestation,the risk of early spontaneous abortion in women with flow signal lengths below the 5th percentile was 10.84 times higher than that in women with flow signal lengths above the 5th percentile of the same gestational week(OR=10.84,95%CI:6.12-19.22,P<0.001).Conclusions:There is a predominant flow signal in the placental villi region during early pregnancy.The too short length of this signal may suggest an increased risk of early spontaneous abortion.

关 键 词：妊娠初期 超声检查 多普勒 胎盘 流产 自然 绒毛区优势血流 

分 类 号：R714.21[医药卫生—妇产科学]