Ophthalmic artery Doppler velocimetry in healthy pregnancy

OBJECTIVES: To establish normative data for ophthalmic artery Doppler parameters throughout a healthy pregnancy, to investigate the possible correlation between these Doppler measurements and gestational age, and to test intraobserver variability. METHODS: A prospective cross-sectional study was performed to assess various Doppler parameters in 276 healthy women between 20 and 39 weeks of gestation. The following measurements were obtained: pulsatility and resistance indices (PI, RI), peak systolic velocity (PSV), peak diastolic velocity (PDV), end diastolic flow velocity (EDFV), and peak ratio (PR). Quantile regression was used to estimate reference values throughout pregnancy and P<0.05 was considered significant. The intraclass correlation coefficient (Intra-CC) was used to calculate intraobserver variability. RESULTS: The 5th and 95th prediction intervals for each gestational age are presented. No significant correlation was detected between Doppler indices and gestational age. Intra-CC was excellent (0.996). CONCLUSIONS: Reference values were generated for ophthalmic artery Doppler measurements, and they did not vary significantly during healthy pregnancy.     

Ultrasound Doppler evaluation of uteroplacental and fetoplacental circulation in pre-eclampsia

Summary Blood flow velocity waveforms (FVW) were recorded weekly from the umbilical and arcuate arteries in 58 hospitalised women with a pregnancy complicated by pre-eclampsia. The maximum velocity waveform was analysed for pulsatility index (PI) and the results from the final antenatal examination were related to the outcome of pregnancy. The umbilical artery FVW was abnormal in 36% of the pre-eclamptic pregnancies, as was the arcuate artery FVW in 42%. No difference in FVW was found between mild and severe pre-eclampsia. Abnormal FVW in the umbilical artery was associated significantly both with intra-uterine growth retardation (IUGR) (P<0.001) and with signs of fetal distress (FD) (P<0.05). Abnormal arcuate artery FVW was associated with FD (P<0.05), but not with IUGR. The outcome of pregnancy was related to Placenta Waveform Class, which was derived from the blood velocity on both maternal and fetal sides of placenta. The results suggest that ultrasound Doppler examination of the umbilical artery is a useful aid in monitoring pregnancies complicated by preeclampsia, but that arcuate artery examination needs further evaluation.     

Angiogenic factors for the prediction of pre-eclampsia in women with abnormal midtrimester uterine artery Doppler velocimetry

OBJECTIVE: To determine whether assessing uterine perfusion and angiogenic factors concurrently in the second trimester improves the prediction of pre-eclampsia and intrauterine growth restriction (IUGR). METHOD: Plasma levels of soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) were measured for 108 women with abnormal uterine perfusion on Doppler velocimetry in the 23rd week. Later, 33 cases of pre-eclampsia and 9 of IUGR developed. RESULTS: Compared with the plasma levels of the women whose pregnancies remained normal, sFlt-1 levels were significantly higher and PlGF levels significantly lower in the women whose pregnancies became complicated by pre-eclampsia and/or IUGR (P<0.001). The alterations were more pronounced in cases of early-onset pre-eclampsia and in cases of IUGR that necessitated delivery before 34 weeks. Using the sFlt-1/PlGF ratio, these complications could be predicted with 98% sensitivity, 95% specificity, and 93% positive predictive value. CONCLUSION: Measuring uterine perfusion and angiogenic factors concurrently in the second trimester improved the prediction of pre-eclampsia and IUGR.     

First trimester uterine Doppler and three-dimensional ultrasound placental volume calculation in predicting pre-eclampsia

OBJECTIVE: To compare the efficacy of uterine artery Doppler velocimetry and three-dimensional ultrasound placental volume calculation alone or in combination in predicting at 11-14 weeks of gestation those pregnancies who will develop pre-eclampsia. STUDY DESIGN: This was a prospective study of 348 nulliparous women scheduled for a routine prenatal ultrasound examination at 11-14 weeks. Color and pulsed wave Doppler was used to obtain uterine artery flow velocity waveforms transabdominally and the mean pulsatility index (PI) of the uterine arteries was calculated. The placental volume was measured by three-dimensional ultrasound using the virtual organ computer-aided analysis. Outcome variables considered were pre-eclampsia and pre-eclampsia requiring delivery <32 weeks. RESULTS: Pre-eclampsia developed in 4.1% of the patients studied and in 1.7% a delivery before 32 weeks was required. Placental volume resulted significantly lower in pregnancies who will develop pre-eclampsia (t=4.636, p<0.003) and this was particularly evident in those pregnancies delivering <32 weeks (t=9.704, p<0.0002). No relationship was found between placental volume and mean uterine artery PI (r=-0.08, p=0.327). Uterine artery PI and placental volume showed similar sensitivities in predicting pre-eclampsia (50% vs. 56%) and pre-eclampsia with delivery <32 weeks (66.7% vs. 66.7%). The combination of uterine artery PI and placental volume gave better results when compared to the single use of one of these parameters (pre-eclampsia sensitivity 68.7%, pre-eclampsia requiring delivery <32 weeks 83.3%). CONCLUSIONS: The combination of abnormal uterine artery Doppler and low placental volume at 11-14 weeks achieves better results than does either test alone in the prediction of pre-eclampsia.     

Combination of uterine artery Doppler velocimetry and maternal serum placental growth factor estimation in predicting occurrence of pre-eclampsia in early second trimester pregnancy: a prospective cohort study

Objective

To determine the effectiveness of the combined use of uterine artery Doppler velocimetry (UADV) and estimation of maternal serum placental growth factor (PlGF) levels in early second trimester (20–22 weeks of gestation) in identifying pregnant women at risk of developing pre-eclampsia.

Study design

Prospective cohort study on 1104 pregnant women with singleton pregnancies between May 2009 and December 2010. UADV and maternal serum PlGF estimation were done at 20–22 weeks’ gestation. Association between the two variables and the occurrence of pre-eclampsia was analyzed by logistic regression analysis and odds ratio was computed. The results were considered significant when p was <0.05.

Results

Logistic regression analysis showed that both abnormal UADV (odds ratio (OR) 4.1; 95% CI 2.3–7.2; p = 0.000) and serum PlGF < 188 pg/ml (OR 3.6; 95% CI 1.95–6.5; p = 0.000) are independent variables in the occurrence of pre-eclampsia, and the difference between the association of these two variables with pre-eclampsia was statistically insignificant as 95% CI values overlap. Multivariate logistic regression analysis showed that a combination of abnormal UADV and serum PlGF < 188 pg/ml at 20–22 weeks had a very poor association (OR 1.1; 95% CI 0.3–3.8; p = 0.938) with the occurrence of pre-eclampsia, as the 95% CI values encompass 1 and p is >0.05.

Conclusion

UADV and maternal serum PlGF estimation at 20–22 weeks of gestation are strong predictors of the occurrence of pre-eclampsia when used individually but in combination their association with pre-eclampsia is not significant.     

Colour Doppler ultrasound of spiral artery blood flow in the prediction of pre-eclampsia and intrauterine growth restriction

Pre-eclampsia and intrauterine growth restriction are responsible for significant maternal and fetal morbidity and mortality worldwide. Identifying pregnancies at highest risk for their development would allow increased surveillance in individual pregnancies and also allow therapeutic trials to decrease their incidences in the future. To date, multiple attempts to develop a screening test for these disorders have met with limited success. Proposed screening methods have included maternal serum biochemical parameters as well as ultrasonographic markers. Uterine artery Doppler, direct evaluation of the spiral arteries using colour and spectral Doppler, three-dimensional placental volume analysis and, most recently, three-dimensional power Doppler angiography have all been suggested. Although an adequate screening method remains elusive, advances in ultrasound technology have improved our ability to observe the pathophysiologic changes that occur with these conditions early in pregnancy, bringing us closer to a reproducible screening model.     

Doppler ultrasound of the uterine artery in the prediction of severe complications during low-risk pregnancies

Aim The aim of this prospective study was to assess the role of uterine artery colour Doppler waveform analysis in the prediction of adverse pregnancy outcome such as preeclampsia, intrauterine growth retardation, placental abruption or a combination of outcome parameters.Methods Various uterine artery Doppler ultrasound parameters (RI>0.58, RI>0.7 and unilateral or bilateral notching) were tested. A second objective was to compare the predictive power of uterine artery Doppler ultrasound at 19–22 gestational weeks and 23–26 weeks gestation for an adverse pregnancy outcome.Results The mean time of delivery was 39+0 weeks of gestation. Eight newborns (2%) were delivered before 34 weeks of gestation. The mean birth weight was 3,240 g. Dystrophic fetuses (<10% percentile) were registered in 35 cases (10%). In 31 of the 346 women (9%) a cesarean section was performed because of abnormal fetal heart recording. Preeclampsia was diagnosed in 17 cases (5%). In 5 cases (1.4%) a placental abruption and 2 (0.6%) intrauterine fetal deaths were diagnosed. The sensitivity of notching for the prediction of preeclampsia was 88% and for the prediction of a severe pregnancy complication (preeclampsia and/or intrauterine growth retardation and/or intrauterine fetal death and/or placental abruption) at any gestational age was 62% with relative risks of 9.7 and 2.2, respectively. The sensitivity of notching for severe pregnancy complications requiring delivery before 34 weeks was 64% with a relative risk of 2.4. The sensitivity of notching in the uterine arteries for developing an IUGR was 56% with a relative risk of 1.7.Conclusion The predictive value of uterine artery Doppler for adverse pregnancy outcome in a low-risk population is of limited diagnostic value. Performing uterine artery Doppler studies at 23–26 weeks gestation instead of 19–22 weeks gestation increases the predictive value for adverse pregnancy outcomes.     

Color Doppler analysis of pelvic arteries following bilateral internal iliac artery ligation for severe postpartum hemorrhage

Objective

To compare Doppler blood flow characteristics of the uterine, arcuate, and ovarian arteries of women who underwent bilateral internal iliac artery ligation with those of controls.

Methods

Thirteen women who underwent bilateral internal iliac artery ligation for severe postpartum hemorrhage (PPH) were matched with 15 healthy women of reproductive age. Transvaginal color and pulsed (duplex) Doppler modes were used to visualize the pelvic arteries. The pulsatility index, the resistance index, the systolic/diastolic blood flow ratio, the peak systolic velocity, and the end-diastolic velocity were measured.

Results

The mean age was 26.1 ± 5.2 years in the study group and 27.0 ± 5.4 years in the control group. All participants had regular menstrual periods. There were no significant differences between the groups regarding each of the vascular indices for the uterine, arcuate, and ovarian arteries.

Conclusion

These findings are consistent with published data demonstrating that pelvic circulation is not compromised after bilateral internal iliac artery ligation.     

Uterine artery Doppler velocimetry with leiomyomas

The study was conducted to establish a correlation between Doppler velocimetry in relation to uterine weight in any phase of the menstrual cycle and symptoms in women who have leiomyomas. Doppler velocimetry was carried out on both uterine arteries in 18 pre-menopausal women and one post-menopausal woman prior to undergoing abdominal hysterectomy at Winthrop University Hospital in Mineola, NY and at Ioannina University Hospital. The t-test was used for statistical analysis. Changes in flow velocity correlatd directly with uterine size. When a division at 500 g was used, S/D ratio was 2.74±0.53 for larger uteri vs. 4.2±1.24 for smaller uteri, p<0.006. Eight women presented heavy bleeding and the mean S/D ratio was 3.75±1.36 while eleven women presented mild bleeding and the mean S/D ratio was 3.51±1.2 (p>0.5). Thus the study has demonstrated that in cases of uterine leiomyomas, the uterine artery flow increases although angiography had previously shown decreased vascularity within the tumor. Received: 9 April 1997 / Accepted: 22 December 1997     

Pharmacological management of severe pre-eclampsia

(Very) High blood pressure in pre-eclamptic women poses a serious risk of acute cerebrovascular complications in these women, necessitating the use of antihypertensive treatment in pre-eclampsia. In this review, the different antihypertensive drugs used in the management of pre-eclampsia are discussed with a focus on efficacy and maternal and neonatal safety. The characteristics of each drug are summarised, including placental transfer, and comparisons between antihypertensive drugs are shown, based on recent publications. Special emphasis is given on newer developments including treatment with ketanserin or nicardipine. Especially nicardipine seems to be a potent drug in the treatment of pre-eclampsia, but comparative trials are needed.     

早发型重度先兆子痫的临床界定及保守治疗探讨

目的　探讨早发型重度先兆子痫的临床界定及保守治疗的临床意义。方法　回顾分析1988年9月至2004年4月,北京大学第三医院收治的255例无严重并发症及合并症的重度先兆子痫患者的临床资料,按重度先兆子痫发病孕周分为4组:A组<28周, 24例; B组28~31周, 50例;C组32~33周, 34例;D组≥34周, 147例。主要分析指标包括:发病孕周、终止妊娠孕周、孕周延长时间、严重并发症发生情况、胎儿及新生儿死亡率和小于孕龄儿发生率。结果　(1)A组保守治疗时间平均为(9 ±8)d,B组为(11±8)d,C组为(8±6)d,D组为(5±4)d,D组保守治疗时间与前3组比较, 差异有统计学意义(P<0 .01 )。而A、B、C各组间的保守治疗时间比较,差异无统计学意义(P>0. 05)。A、B、C各组孕妇并发症发生率比较,差异也无统计学意义(P>0 .05 ),但与D组比较,差异有统计学意义(P<0 .01);A、B组胎儿及新生儿死亡率、胎死宫内发生率与C、D组比较,差异均有统计学意义(P<0 .01),而C、D两组间比较,差异无统计学意义(P>0 .05)。(2)多因素logistic回归分析显示,重度先兆子痫发病孕周,是影响孕妇并发症发生率的重要因素,而与保守治疗时间无相关性。终止妊娠孕周是影响胎儿及新生儿死亡率的主要因素,其次为发病孕周。(3)以32孕周为界值进行多因素分析显示,终止妊娠孕周     

Increased visfatin and leptin in pregnancies complicated by pre-eclampsia

Objective.?To evaluate the role of the adipokines, visfatin and leptin in the pathophysiology of pre-eclampsia and how their concentrations correlate with the severity of the disease and abnormal Doppler velocimetry.

Methods.?A cross-sectional study was carried out in 72 pregnant women (30 patients with mild pre-eclampsia, 20 patients with severe pre-eclampsia and 22 healthy normotensive pregnant women) during the third trimester of pregnancy. The maternal levels of plasma visfatin and serum leptin were determined in all cases by enzyme immunoassay and enzyme-linked immunosorbent assay, respectively. The uterine artery and umbilical artery RI were determined by Doppler analysis in all cases.

Results.?Plasma visfatin levels and serum leptin levels were higher in patients with pre-eclampsia than in the normotensive pregnant women. Six patients with mild pre-eclampsia and five patients with severe pre-eclampsia had abnormal Doppler velocimetry. Visfatin and leptin levels of pre-eclamptic patients with abnormal Doppler velocimetry were significantly higher than they were in those with normal Doppler velocimetry. Serum leptin levels were positively correlated with plasma visfatin level in cases of pre-eclampsia.

Conclusions.?These findings suggest that increased maternal levels of leptin and visfatin may be involved in the pathogenesis of pre-eclampsia, and measurement of these adipokines may be useful in assessment of the severity of disease.     

Uterine artery Doppler and urinary hyperglycosylated HCG as predictors of threatened abortion outcome

ObjectiveTo study the role of uterine artery Doppler and urinary hyperglycosylated hCG (hCG-H) in predicting threatened abortion outcome.MethodsA prospective observational study was conducted on 93 cases with threatened abortion (study group) and 50 cases with normal pregnancy (control group) at 6–12 weeks of gestation. Uterine artery Doppler examination was performed and urinary hCG-H was measured in all cases. Cases were followed up till delivery and the number of aborted cases was recorded.ResultsUrinary hCG-H concentration was significantly higher in the control group and in cases who continued than in cases who miscarried 5.3 ± 3.9 vs. 2.1 ± 3.0 mIU/ml equivalents (P = 0.002) for the first and 5.1 ± 4.5 vs. 2.1 ± 3.0 mIU/mlEq (P = 0.003) for the second respectively. The ratio of hyperglycosylated hCG to total hCG was >51% in the 116 term outcome cases while it was below 49% in the 29 cases who miscarried. Unilaterally increased uterine artery pulsatility index and Δ uterine artery pulsatility index values were significantly higher in women who miscarried than in those with continuing pregnancies or the control groups (P < .0001). ROC for uterine artery Doppler revealed an area under the curve AUC of 0.77, while for urinary HCG-H the AUC was 0.82 and for uterine artery Doppler and urinary HCG-H combined the AUC reached 0.93.ConclusionThe unilaterally increased uterine arteries pulsatility index and the decreased urinary hCG-H production in the first trimester could predict miscarriage in threatened abortion.     

Increased plasma levels of the novel vasoconstrictor peptide endothelin in severe pre-eclampsia

Plasma endothelin levels were studied in 29 pregnancies.

Levels were found to be increased in 9 pregnancies complicated by pregnancy-induced hypertensive disease and/or pre-eclampsia as compared to levels in 14 normotensive pregnancies with gestational age varying between 24–40 weeks with normal Doppler flow velocity waveforms of the uterine arcuate arteries, and 6 normotensive pregnancies with abnormal Doppler flow velocity waveforms at 24 weeks' gestation.

Two patients with severe pre-eclampsia showed a rise in plasma endothelin levels, suggesting a correlation between plasma endothelin levels and the disease process. Endothelin is produced by endothelial cells of blood vessels; it is the most potent vasoconstrictor known to date. For this reason it has been suggested that endothelin might be important in the control of systemic blood pressure and local blood flow, both disturbed in pre-eclampsia. The conclusion of this study is that the venous plasma level of endothelin would seem to be a marker for severe disease, however, without any predictive value.     

重度子(癎)前期合并低蛋白血症对围产结局的影响

目的 探讨重度子癎前期合并低蛋白血症对围产结局的影响及其相关性.方法 回顾性分析我院2000年1月至2006年3月收治的233例重度子痢前期患者的临床资料,按血清白蛋白检测结果将其分成低蛋白血症组(A组,133例)和非低蛋白血症组(B组,90例),比较两组孕产妇及围产儿结局.结果 A组孕妇浆膜腔积液(6.8%和0)、肝酶异常(60.9 %和38.9%)、肾功损害(30.1%和11.1%)及并发症(胎盘早剥、产后出血)的发生率(23.3%和11.1%)均高于B组(P<0.05),新生儿出生体重低于B组[(2192.78±795.31)g和(2454.92±776.24)g,P<0.05],围产儿死亡率A组高于B组(26.0%和13.5%)(P<0.05).结论 重度子痢前期合并低蛋白血症可造成母儿的不良结局,应积极防治.充分细致评估母胎状况,尽可能延长孕周改善新生儿结局,若孕妇重要器官受损或并发难治性浆膜腔积液应适时终止妊娠,以改善孕母结局.     

重度子(疒间)前期诊断标准临床意义探讨

目的从临床实践方面进一步探讨我国最近制定的妊娠期高血压疾病重度子疒间前期诊断分类标准的临床意义。方法收集我院1992年1月至2003年12月诊治的妊娠期高血压疾病493例,其中1992年1月至1997年12月6年内按重度妊高征诊断标准诊断的病例73例(A组),1998年1月至2003年12月6年内按重度子疒间前期诊断标准判断的病例119例(B组)。分析493例按我国过去沿用的妊高征分类标准诊断的各类妊高征患者中有关脏器损害的临床症状及体征的发生率,并比较A、B两组不同标准判断的重度子疒间前期的母婴预后。结果重度妊高征中各项有关脏器损害临床表现的发生率较高,中度妊高征亦有一定的发生率,但较重度妊高征低。B组低体重儿、新生儿窒息、严重并发症及子疒间的发生率均较A组低,两组比较差异有显著性意义,两组围生儿死亡率比较差异无统计学意义。结论我国目前参照世界卫生组织通用标准提出的妊娠期高血压疾病重度子疒间前期分类诊断标准体现了有关脏器损害的程度,有一定客观依据和临床价值。包括了过去旧的分类诊断方法中的重度妊高征和部分中度妊高征患者,有利于妊娠期高血压疾病的防治,减少不良妊娠结局。     

骨保护素基因多态性与重度子痫前期发病的关系

目的 探讨骨保护素基因启动子区163A/G和950T/C位点的多态性与重度子痫前期发病的关系.方法 选择2007年7月-2009年3月在四川大学华西第二医院就诊的成都市汉族孕妇共166例.其中重度子痫前期孕妇85例(重度子痫前期组),健康足月孕妇81例(对照组).应用PCR限制性片段长度多态性(RFLP)技术测定两组孕妇骨保护素基因启动子区163A/G和950T/C位点的基因型及等位基因频率,对两组中不同等位基因孕妇的血压、血肌酐、24 h尿蛋白定量、新生儿出生体质量等临床指标进行比较.结果(1)骨保护素基因启动子区163A/G、950T/C位点的基因型及等位基因频率在两组孕妇中的分布均符合Hardy-Weinberg遗传平衡定律.163A/G位点的基因型为AA、AG、GG,等位基因为A、G;950T/C位点的基因型为TT、TC、CC,等位基因为T、C.(2)重度子痫前期组孕妇163A/G、950T/C位点的基因型、等位基因频率与对照组比较,差异均无统计学意义(P＞0.05).(3)重度子痫前期组中163A/G位点AG+ GG基因型孕妇血肌酐水平[(76±24)μmol/L]明显高于AA基因型孕妇[(56±18)μmol/L],而新生儿出生体质量[(2040±721)g]显著低于AA基因型孕妇[(2520±810)g],两者比较,差异均有统计学意义(P＜0.05).对照组中163A/G位点的AG+ GG基因型孕妇血尿素、血肌酐、新生儿出生体质量、新生儿身长等临床指标与AA基因型孕妇比较,差异均无统计学意义(P＞0.05).(4)重度子痫前期组中950T/C位点的TT基因型孕妇收缩压[(153±16)mm Hg(1 mm Hg =0.133 kPa)]、24 h尿蛋白定量[(4.0±2.5)g]均显著高于TC+ CC基因型孕妇[分别为(145±17)mmHg及(2.9±1.8)g],两者比较,差异均有统计学意义(P＜0.05);而对照组中950T/C位点的不同基因型孕妇各临床指标之间比较,差异均无统计学意义(P＞0.05).结论 携带163A/G位点的G等位基因孕妇比携带A等位基因者更具有重度子痫前期遗传易感性;携带950T/C位点的T等位基因孕妇比携带C等位基因者也更具有重度子痫前期遗传易感性.提示骨保护素基因多态性可能与重度子痫前期的发病有关.     

Doppler blood flow velocity waveforms in the fetal renal artery

Summary In 19 out of 20 human fetuses we recorded blood velocity waveforms in the renal artery by means of a duplex Doppler sector scanner. One fetus was at 22 weeks gestation, 7 fetuses were between 32 and 35 weeks, and 12 fetuses between 36 and 40 weeks. There was no evidence of intrauterine growth retardation and there was a normal quantity of amniotic fluid in all pregnancies. We also recorded waveforms in the umbilical artery, the descending aorta, and the internal carotid artery. The RI in these vessels showed normal values in all cases. There was no end-diastolic flow in four of the seven fetuses studied at 32 to 35 weeks gestation. The mean RI of fetuses with end-diastolic flow was 0.86 (SD 0.03). The interpretations of these results, and ideas for future studies are discussed.     

131例双胎妊娠并发重度子痫前期的妊娠结局

目的 探讨双胎妊娠并发重度子痫前期孕产妇的临床特点及其妊娠结局.方法 研究对象为2007年6月至2011年6月期间,四川大学华西第二医院收治的703例重度子痫前期病例,其中双胎妊娠131例,单胎妊娠572例.采用回顾性分析的方法,比较双胎组和单胎组孕妇的年龄、规律产检次数、发病孕周、分娩孕周、平均延长孕龄、血压值及实验室检测结果等临床指标,比较胎盘早剥、产后出血、子宫胎盘卒中、子痫、HELLP综合征(hemolysis,elevated liver enzymes,and low platelets syndrome)等产科并发症,以及心功能衰竭、肺水肿、低蛋白血症、视网膜病变、颅内出血和肾功能不全等并发症发生情况.比较双胎组和单胎组围产儿的结局,包括早产率、围产儿死亡率、新生儿重症监护室(neonatal intensive care unit,NICU)转入率,以及胎儿窘迫、新生儿缺血缺氧性脑病(hypoxie ischemic encephalopathy,HIE)、新生儿窒息、肺炎、高胆红素血症和低血糖等疾病的发生率.采用t检验、x2检验、校正四格表的x2检验或Fisher精确概率法进行统计学分析.结果 双胎组重度子痫前期发病率高于单胎组[5.03％(131/2604)与1.94％(572/29 452),x2=106.40,P＜0.001].双胎组和单胎组的平均发病孕周分别为(33.6±1.8)周和(34.4±2.0)周,平均分娩孕周分别为(34.6±2.9)周和(35.6±3.2)周,平均延长孕龄分别为(6.4±0.3)d和(7.4±0.5)d,双胎组均早于单胎组(t=2.364、3.902和5.314,P均＜0.05).双胎组与单胎组胎盘早剥[9.9％(13/131)与4.2％(24/572)]、心功能衰竭[11.5％ (15/131)与3.2％ (18/572)]、肺水肿[4.6％(6/131)与0.9％(5/572)]、产后出血[16.0％(21/131)与7.0％ (40/572)]、子宫胎盘卒中[5.3％(4/131)与0.5％(3/572)]发生率比较,双胎组均高于单胎组(x2=7.013、16.430、9.505、10.990和17.650,P均＜0.01).双胎组与单胎组早产率[77.1％ (202/262)与29.9％(171/572)]、新生儿HIE发生率[8.4％(22/262)与4.7％(27/572)]、新生儿NICU转入率[76.2％(205/262)与58.4％(332/572)]比较,双胎组均高于单胎组(x2=162.000、4.392和31.980,P均＜0.05).结论 双胎妊娠较单胎妊娠更易发生重度子痫前期,且更易发生严重并发症,导致围产儿不良结局.临床应重视双胎妊娠的管理,一旦发生妊娠期高血压疾病应积极治疗并预防并发症,根据病情适时终止妊娠.