胎儿脐动脉舒张末期血流缺失22例分析及妊娠结局

目的探讨妊娠期发生脐动脉舒张末期血流缺失（absentend—diastolic velocity，AEDV）的原因及与围生儿结局的关系。方法对2009年1月至2011年12月北京大学第一医院22例AEDV母儿的临床资料进行回顾性分析，并追踪妊娠结局。结果22例孕妇中，17例有合并症或并发症，5例无合并症或并发症。17例患者中，子痫前期13例，其中合并胎儿生长受限（FGR）5例，慢性高血压并发子痫前期1例，肾源性高血压并发子痫前期3例；单纯FGR者1例。慢性高血压合并妊娠1例；先天性心脏病（法洛四联症术后）1例；原发性抗磷脂综合征1例。双胎妊娠2例，其中选择性FGR1例，死胎1例；胎儿畸形3例，分别为尿道下裂、房间隔缺损及染色体异常（21-三体），其中胎儿房间隔缺损孕妇合并重度子痫前期和FGR。结论以子痫前期为主的妊娠并发症是妊娠中晚期胎儿脐动脉血流缺失的主要病因。双胎妊娠中AEDV与选择性FGR有关。在无明确合并症或并发症的情况下出现AEDV应进一步寻找胎儿原因。

Analysis of pregnancy with absent end- diastolic velocity in umbilical artery

Objective To investigate the pregnancy with absent end - diastolic velocity （AEDV） in umbilical artery cases, and to explore the possible reasons that affect the perinatal outcome. Methods Data of twenty- two pregnant women with AEDV admitted into Peking University First Hospital from January 2009 to December 2011 were retrospectively analyzed. Results Among the 22 patients, 17 had complications; 13 patients were preeclamp- sia, 5 of which concurrent FGR, 1 concurrent chronic hypertension, 3 were renal hypertension; 1 patient was con- genital tertalogy of fallot; 1 patient was primary antiphospholipide syndrome; 2 cases were twin pregnancy, 1 of which was considered selective FGR （sFGR） ; 3 cases were associated with fetal malformations （one Down syndrome）. Conclusion Most of the AEDV patients had complications, especially preeclampsia. Besides, part of the AEDV patients were fetal malformation related.