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目的探讨多普勒超声在妊娠期高血压疾病孕妇子宫动脉及脐动脉血流检测中的应用价值。方法选择2013年5月-2015年5月宁波市北仑区第二人民医院收治的137例妊娠期高血压疾病孕妇为观察组,120例同期正常孕妇作为对照组,两组孕妇分别于妊娠早期、妊娠中期以及妊娠晚期进行多普勒超声检查,比较两组孕妇子宫动脉血流动力学、胎儿脐动脉血流动力学及新生儿体质量、Apgar评分。结果随着孕期的延长,对照组孕妇PI、RI以及S/D值均显著降低,观察组PI、RI以及S/D值先升高后降低;观察组孕妇妊娠中期、妊娠晚期PI、RI以及S/D值显著高于对照组(P<0.05)。两组胎儿妊娠晚期脐动脉血流PI、RI以及S/D值均较妊娠中期显著降低(P<0.05),且妊娠中期、妊娠晚期妊娠期高血压疾病胎儿脐动脉血流PI、RI以及S/D值显著高于对照组(P<0.05)。观察组新生儿体质量显著低于对照组(P<0.05),且观察组新生儿Apgar评分显著高于对照组(P<0.05)。结论妊娠中期、妊娠晚期妊娠期高血压疾病孕妇子宫动脉血流以及脐动脉血流阻力与正常妊娠比较显著升高,胎盘血流灌注可引起胎儿缺血缺氧和生长受限。
Objective To investigate the value of Doppler ultrasound in the detection of uterine artery and umbilical artery blood flow in pregnant women with hypertensive disorder of pregnancy. Methods From May 2013 to May 2015, 137 pregnant women with gestational hypertension disease admitted to the Second People’s Hospital of Beilun District in Ningbo City were enrolled as observation group and 120 normal pregnant women as control group. Pregnant women in the two groups were divided into two groups: early pregnancy, Doppler ultrasound was performed in the second trimester of pregnancy and in the third trimester of pregnancy. The uterine artery hemodynamics, fetal umbilical artery hemodynamics, neonatal weight and Apgar score were compared between the two groups. Results With the extension of pregnancy, the PI, RI and S / D values of pregnant women in the control group were significantly decreased. The PI, RI and S / D values of the control group first increased and then decreased. The PI, RI, The S / D value was significantly higher than that of the control group (P <0.05). The PI, RI and S / D values of umbilical artery blood flow in the two groups were significantly lower than those in the second trimester (P <0.05), and the umbilical arterial blood flow PI, RI, and S in gestational hypertensive disorders / D value was significantly higher than the control group (P <0.05). The neonatal weight in the observation group was significantly lower than that in the control group (P <0.05), and the Apgar score in the observation group was significantly higher than that in the control group (P <0.05). Conclusion Pregnancy uterine artery blood flow and umbilical artery blood flow resistance are significantly increased in the third trimester of pregnancy compared with normal pregnancy. The placental perfusion can cause fetal ischemia, hypoxia and limited growth.