子宫动脉多普勒波型正常化的延迟不是一种良性现象

• 作 者: Kurdi W. V.rington K. 张影
• 机 构: Acad. Dept. of Obstet. and Gynaecol., Bart’s London Sch. of Med. and Dent., Qu. Mary Univ. London, H
• 出 处: 世界核心医学期刊文摘(妇产科学分册)
• 发表日期: 2005年04期
• 关键词: 子宫动脉 波型 胎盘早剥 妊娠结局 孕妇 多普勒血流速度 妊娠晚期 围生期死亡率 妊娠并发症 小于胎龄儿

Objective: To evaluate the pregnancy outcome in patients with abnormal uterine artery Doppler flow velocity waveforms (FVWs) at 19-21 weeks, which were subsequently normal by 24-26 weeks, and to study the effect of lowdose aspirin on these waveforms. Design: The study group consisted of 49 patients who had abnormal uterine artery flow velocity waveforms (FVWs) at 19-21 weeks. These women were initially commenced on 100 mg slowrelease aspirin at 20 weeks, which was discontinued at the followup visit, after confirming normal uterine artery Doppler FVW. The control group consisted of 730 patients with normal uterine artery Doppler waveforms at 19-21 weeks. The main outcome measures were: small for gestational age (SGA) < 10th centile, preeclampsia, placental abruption, and perinatal mortality rate (PMR). Results: When compared with the control group, the study group had an increased risk of placental abruption (2%versus 0.27%, P=0.05) 95%Confidence Intervals CI=0.01-0.13), low birth weight (3087 versus 3383 gm, P=0.0003), SGA <10th centile (32.7%versus 11.9%, P≤0.0001, CI=0.14-0.5), and PMR (2/49 versus 1/730, P < 0.0001, CI=0.003-0.37). Conclusions: These findings suggest that delayed normalisation of the uterine artery Doppler waveform is not a benign phenomenon. This subgroup of patients is at increased risk of pregnancy complications, in particular SGA and placental abruption. These patients could benefit from serial ultrasound scans in the third trimester to evaluate fetal growth and wellbeing. Aspirin does not appear to play a major part in modifying uterine artery blood flow.

Objective: To evaluate the pregnancy outcome in patients with abnormal uterine artery Doppler flow velocity waveforms (FVW  s) at 19-21 weeks, which were subsequently normal by 24-26 weeks, and to study the effect of lowdose aspirin on these The study consisted of 49 patients who had abnormal uterine artery flow velocity waveforms (FVWs) at 19-21 weeks. These women were initially commenced on 100 mg of slow asprein at 20 weeks, which was discontinued at The follow -up visit, after confirming normal uterine artery Doppler FVW. The control group consisted of 730 patients with normal uterine artery Doppler waveforms at 19-21 weeks. The main outcome measures were: small for gestational age (SGA) <10 centile, Pre-eclampsia, placental abruption, and perinatal mortality rate (PMR). Results: When compared with the control group, the study group had an increased risk of placental abruption (2% versus 0.27%, P = 0.05) 95% Confidence Intervals CI = 0.01-0.13 , low birth weight (3087 versus 3383 gm, P = 0.0003), SGA <10 centile (32.7% versus 11.9%, P ≦ 0.0001, CI = 0.14-0.5), and PMR (2/49 versus 1/730, P <0.0001, CI = 0.003-0.37). Conclusions: These findings suggest that delayed normalisation of the uterine artery Doppler waveform is not a benign phenomenon. This subgroup of patients is at increased risk of pregnancy complications, in particular SGA and placental abruption. These patients could benefit from serial ultrasound scans in the third trimester to evaluate fetal growth and well-being. Aspirin does not appear to play a major part in modifying uterine artery blood flow.