初产妇子宫动脉频谱多普勒超声表现与妊娠期高血压疾病的关系及对妊娠结局的影响

目的探讨初产妇子宫动脉血流阻力指数(RI)、舒张早期切迹与妊娠期高血压疾病的关系及对妊娠结局的影响。方法选择妊娠20周初产妇632例,测量双侧子宫动脉RI,计算其均值,并观察舒张早期切迹;其中483例RI≤0.58为RI正常组1,149例RI>0.58于妊娠26周再次测量,75例RI≤0.58为RI正常组2,49例RI>0.58为RI异常组。结果 RI正常组1和RI正常组2高血压疾病的发生率差异无统计学意义,故将两组合并为RI正常组。RI异常组的高血压疾病发生率和不良妊娠结局的发生率高于RI正常组。妊娠26周时,有舒张早期切迹的产妇妊娠期高血压疾病及子痫前期、子痫的发生率分别是66.7%、13.3%,高于无切迹者(P<0.05)。结论初产妇子宫动脉RI增高是早期发现妊娠期高血压的一项较敏感指标。

The relationship between uterine artery spetral Doppler ultrasound and gestational hypertension in primipara and its influence on pregnancy outcome

Objective To explore the relationship between uterine artery spectral Doppler uhrasound and gestational hypertension in primipara and its influence on pregnancy outcome. Methods Six hundred and thirty-two primipara at 20-week gestation were enrolled in this study. Resistance index（RI ） of uterine artery and early diastolic notch were measured and observed. 483 patients with RI~〈0.58 were set to normal RI group 1. 149 patiewts with RI〉0.58 were measured again at 26-week gestation. 75 cases of them with RI ~〈 0.58 were set to normal RI group 2, and 49 cases with RI〉0.58 were set to abnormal RI group. Results There was no significant difference in hypertension incidence between normal RI group 1 and normal RI group 2. So the two groups were merged into normal RI group. The incidence of hypertension and adverse pregnancy outcome in abnormal RI group was higher than those in normal RI group. The incidence of hypertension, preeclampsia and eclampsia in primipara with early diastolic notch at 26-week gestation was 66.7% and 13.3%, respectively（P 〈0.05）. Conclusion Increased RI of uterine artery in primipara is a more sensitive indicator for early detection of gestational hypertension.