不同妊娠状态下子宫动脉及脐动脉血流动力学特点

摘要

目的:通过对正常妊娠及不良妊娠妇女早、中、晚三期子宫动脉及脐动脉血流动力学系统相关指标的纵向序贯观察,了解不同妊娠状态下子宫、脐血流动力学特点.方法:回顾性分析2005年1月～2010年1月于我院产科确诊并资料齐全的妊娠期高血压疾病患者188例(A组)、胎儿宫内生长受限患者73例(B组)、羊水过少患者104例(C组),统计分析其妊娠早期(10～14周)、妊娠中期(20～24周)及妊娠晚期(30～34周)彩色多普勒测定子宫动脉及脐动脉血流收缩期最大血流速度与舒张末期血流速度的比值(S/D)、脉搏指数(PI)、阻力指数(RI).另外,选取100例资料齐全的正常妊娠者作为对照组(D组).结果:A组妊娠中期及妊娠晚期的S/D、PI及RI与D组比较均有显著性差异;B组妊娠中期PI、妊娠晚期S/D及RI与D组比较差异有统计学意义(P<0.05);C组患者妊娠中期S/D,及妊娠晚期PI与D组比较差异有统计学意义(P<0.05).与C组比较,A组妊娠中期、晚期脐动脉S/D、PI及RI均升高,B组妊娠中期PI、RI及妊娠晚期S/D及PI较高;C组妊娠中期S/D,除B组妊娠中期S/D、PI升高,妊娠晚期S/D及RI升高,差异有统计学意义(P<0.05).结论:妊娠期间常规监测子宫动脉及脐动脉血流动力学指标对监测不良妊娠事件有着非常重要的作用.%Objective: To investigate the hemodynamics characteristics of uterine and umbilical arteries in normal pregnancy and abnormal pregnancy, when they were in the first, second and third trimesters of pregnancy.Methods: 188 pregnant women with pregnancy induced hypertension (PIH, group A), 73 pregnant women with intrauterine growth retardation (IUCR, group B) and 104 pregnant women with oligohydramnios (group C), they were selected and analyzed retrospectively.Doppler ultrasound were given to observe S/D, RI and PI of uterine arteries in 10th to 14th week, 20th to 24th week and 30th to 34th week for all pregnant women.Meanwhile, the author chose 100 normal pregnant women as control group (group D).Results: Uterine arteries' RI, PI and S/D took on the decreasing tendencies following the gestation weeks in the four groups.Uterine arteries' RI, PI and S/D of group A were higher than group D in the second and third trimesters of pregnancy (P＜0.05); the uterine arteries' RI, PI and S/D of group B were higher than group D in the second and third trimesters of pregnancy (P＜0.05); in group C, the uterine arteries' S/D in the second trimesters of pregnancy and the uterine arteries' PI in the third trimesters of pregnancy were higher than group D (P＜0.05).Compared with group D, uterine arteries' RI, PI and S/D of group A increased in the second and third trimesters of pregnancy; in group B, uterine arteries' RI, PI in the second trimesters of pregnancy and PI, S/D in the third trimesters of pregnancy were more higher.Conclusion: Making a examinational on hemodynamics of uterine and umbilical arteries should be recommended to pregnant women in order to detect abnormal pregnancy.