| 摘要: |
| 目的 建立妊娠11~13+6周子宫动脉多普勒参数在低危人群中的正常参考值，同时评估其对不良妊娠结局的预测价值。方法 收集2019年6月至2021年6月于我院行产前超声检查的妊娠11~13+6周孕妇，根据妊娠结局分组。收集两侧子宫动脉多普勒指标，包括搏动指数（PI）、阻力指数（RI）、舒张早期是否有切迹，以及孕妇基本临床资料和胎儿出生信息，将以上相关参数进行统计学分析。结果 最终纳入800例孕妇，包括正常妊娠结局组740例和不良妊娠结局组60例。两组孕妇体质量指数（BMI）、分娩孕周和胎儿出生体质量比较，差异均有统计学意义（均P＜0.05）。随着孕周的增加，子宫动脉两侧平均搏动指数（mPI）、平均阻力指数（mRI）和两侧舒张早期切迹检出率均呈逐渐下降的趋势。ROC曲线分析显示，mPI、mRI及两侧舒张早期切迹预测妊娠结局的曲线下面积（AUC）分别为0.542、0.574、0.521，三者联合预测妊娠结局的AUC为0.648；孕妇BMI、年龄mPI、mRI及两侧舒张早期切迹预测妊娠结局的AUC为0.751。结论 建立了低危人群在妊娠11~13+6周子宫动脉多普勒参数的正常参考值范围。在妊娠11~13+6周单纯应用子宫动脉多普勒参数预测妊娠结局的价值有限，将子宫动脉参数与临床相关指标结合可提高对不良妊娠结局的预测价值。 |
| 关键词: 早孕期 子宫动脉 多普勒 阻力指数 搏动指数 妊娠结局 |
| DOI： |
| 投稿时间：2022-05-08修订日期：2022-09-11 |
| 基金项目:上海交通大学医工交叉基金(ZH2018QNA35；YG2021QN140) |
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| The value of using uterine artery Doppler parameters at the first trimester pregnancy to predict pregnancy outcomes in a low-risk population |
| Meng Fanhui,Wang Hui,Zeng Min,Gong Xiaoping,Wang Haifei,Wang Guanjie,Cao Yunyun |
| (1. The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; 2. Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China; 3. Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China) |
| Abstract: |
| Objective The aims of this study were to establish the normal reference range of uterine artery doppler parameters at the generation of 11~13+6 weeks in low risk population，and to evaluate its value in predicting pregnancy outcomes. Methods The Doppler parameters of bilateral uterine artery including pulsatility index （PI），resistance index （RI） and the presence or absence of early diastolic notching were examined by abdominal ultrasonography at 11~13+6 weeks of pregnancy，and the demographic characteristics and pregnancy outcome were collected. The above related parameters were statistically analyzed. Results A total of 800 patients were eligible for inclusion in this study，including 740 patients in the normal pregnancy outcome group and 60 patients in the adverse pregnancy outcome group. With the exception of body maternal index，fetal gestational age and birth weight at delivery，there was no difference in demographic characteristics between the two groups of pregnancy outcome （P<0.05）.The mean pulsatility index （mPI） and mean resistence index （mRI） show a progressive decline from 11 to 13+6 weeks，the prevalence of bilateral notching was gradually decreased with the increase of gestational age. The area under the curve （AUC） of mPI，mRI and bilateral notching for predicting pregnancy outcome was 0.542，0.574 and 0.521，respectively，and the AUC of the combination of the three parameters for predicting pregnancy outcome was 0.648.The results of the ROC curve analysis demonstrated the prognostic value of the combination of BMI，age，mPI，mRI and bilateral notching was 0.751.Conclusions The normal reference range of uterine artery doppler parameters was established in the low risk population at 11 to 13+6 weeks of pregnancy.There is limited value in using only uterine artery doppler parameters to predict pregnancy outcomes at 11–13+6 weeks gestation.A combination of clinical characteristics and uterine artery Doppler ultrasound can more effectively predict adverse pregnancy outcomes in low risk population. |
| Key words: first trimester uterine artery doppler pulsatility index resistance index pregnancy outcome |
