胎儿血流动力学参数与妊娠期高血压孕妇围产儿结局的相关性  

The Relationship between Hemodynamic Parameters Measured by Ultrasound and Perinatal Outcomes in Pregnant Women with Hypertension during Pregnancy

作　　者：马静 王娟[2] MA Jing;WANG Juan(Department of Ultrasound Medicine,Baoji Maternal and Child Health Care Hospital,Baoji Shaanxi 721000)

机构地区：[1]宝鸡市妇幼保健院超声医学科,陕西宝鸡721000 [2]西北大学第一医院,陕西西安710043

出　　处：《医学临床研究》2023年第8期1193-1196,共4页Journal of Clinical Research

摘　　要：【目的】探讨胎儿血流动力学参数与妊娠期高血压孕妇围产儿结局的相关性。【方法】选取2018年8月至2021年8月在宝鸡市妇幼保健院定期产检的65例妊娠期高血压孕妇,按照血压情况分为轻度组(收缩压140~160 mmHg,舒张压90~110 mmHg,n=33)和重度组(收缩压>160 mmHg,舒张压>110 mmHg,n=32),另外选择同期在宝鸡市妇幼保健院定期产检的正常孕妇为正常组(n=21),采用多普勒超声检测胎儿血流动力学参数并比较,比较各组妊娠结局。【结果】三组胎儿脐动脉阻力指数(RI)、血流速度峰谷比(S/D)、搏动指数(PI)比较,正常组<轻度组<重度组(P<0.05);三组大脑中动脉PI、RI、S/D比较,正常组>轻度组>重度组(P<0.05);正常组、轻度组、重度组新生儿出生体重、胎盘重量、Apgar评分、脐动脉pH值、分娩时孕周依次降低(P<0.05),剖宫产率依次增加(P<0.05)。86例产妇(包括妊娠期高血压患者65例和正常妊娠产妇21例)中正常妊娠结局56例(正常组)、轻度不良结局25例(轻度不良组)、重度不良结局5例(重度不良组),三组脐动脉PI、RI、S/D比较,正常组<轻度不良组<重度不良组(P<0.05);三组大脑中动脉PI、RI、S/D比较,差异无统计学意义(P>0.05)。采用Logistic回归分析结果显示:脐动脉参数PI、RI、S/D均是不良妊娠结局的影响因素(OR分别为2.614、2.396、3.445,均P<0.05)。【结论】胎儿血流动力学参数可用于预测胎儿宫内发育状态,评估妊娠期高血压孕妇的病情进展及不良妊娠结局。【Objective】To explore the correlation between ultrasound-measured hemodynamic parameters and perinatal outcomes in pregnant women with hypertension.【Methods】A total of 65 pregnant women with pregnancy-induced hypertension diagnosed in Baoji Maternal and Child Health Care Hospital from August 2018 to August 2021 were selected as the study subjects.Patients were divided into the mild group(n=33,systolic pressure 140-160 mmHg,diastolic pressure 90-110 mmHg)and the severe group(n=32,systolic pressure>160 mmHg,diastolic pressure>110 mmHg).During the same time period,normal pregnant women who received regular prenatal checkups in Baoji Maternal and Child Health Hospital were selected as the normal control group(n=21).The fetal hemodynamic parameters were detected by Doppler Ultrasonic testing.The fetal hemodynamic parameters with different pregnancy outcomes were analyzed.【Results】Comparison of umbilical artery resistance index(RI),peak to valley ratio of blood flow velocity(S/D),and pulsation index(PI)parameters among three groups of fetuses showed:normal group<the mild group<the severe group(P<0.05).While comparison of PI,RI,and S/D parameters of middle cerebral artery among three groups showed:normal group>the mild group>the severe group(P<0.05).Results of the birth weight,placental weight,Apgar score,umbilical artery PH value,and gestational week at delivery showed the decreased order in normal group,the mild group and the severe group,while the rate of cesarean section increased in turn of normal group<mild group<severe group(P<0.05).Among the 86 pregnant women(including 65 patients with gestational hypertension and 21 normal pregnant women),56 cases had normal pregnancy outcome in the perinatal period,25 had mild adverse outcome,and 5 had severe adverse outcome.Comparison of the PI,RI,and S/D parameters of the umbilical artery among the three groups showed the order of adverse severity as the normal group<the mild adverse outcome<the severe adverse outcome(P<0.05).There were no statistically significa

关 键 词：高血压 妊娠性 血流动力学 妊娠结局 

分 类 号：R714.252[医药卫生—妇产科学]