Uterine Doppler velocimetry and placental hypoxic-ischemic lesion in pregnancies with fetal intrauterine growth restriction
Uterine Doppler velocimetry and placental hypoxic-ischemic lesion in pregnancies with fetal intrauterine growth restriction
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DOI：
10.1053/plac.1999.0395
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发表时间：
1999-07-01
期刊：
影响因子：
3.8
通讯作者：
Pardi, G
中科院分区：
文献类型：
--
作者：
Ferrazzi, E;Bulfamante, G;Pardi, G
为探讨胎儿宫内生长受限（IUGR）病例的子宫动脉上行多普勒血流速度（Ut.DV）能否反映胎盘缺氧缺血性病变的存在，以及这种预测是否受母体血压水平的影响，对90例IUGR孕妇和37例正常对照孕妇在分娩后7天内进行了Ut.DV检测。异常Ut.DV定义为（左和右收缩）/舒张比>2.6和舒张期切迹的平均值。在IUGR患者中，Ut. DV异常者胎盘病变总发生率明显高于Ut. DV正常者，且Ut. DV异常者胎盘病变总发生率明显高于Ut.DV正常者，且Ut.DV异常者胎盘病变总发生率明显高于Ut.DV正常者（相对危险度6.35; 95%置信区间=5.2-7.3）。这些病变的发生率和严重程度在正常血压妊娠和高血压妊娠之间没有显著差异（87%对93%; P=0.2）。当Ut.DV正常时，IUGR病例和对照妊娠的胎盘病变率相似（14%对8%; P=0.69）。围产期的结局是没有显着不同的任何正常血压和高血压妊娠与生长受限的胎儿和异常UT。DV。异常多普勒血流速度的存在下，胎儿宫内生长受限的妊娠子宫动脉实际上可能是缺氧或缺血性胎盘病变的一个重要指标。这种异常的多普勒血流速度与母体血压状态无关。(C)小行星1999 W. B。Saunders Company Ltd
We tested the hypothesis that Doppler velocimetry of the ascending uterine arteries (Ut.DV) in cases of fetal intrauterine growth restriction (IUGR) can reflect the presence of hypoxic-ischaemic lesions of the placenta, and whether this prediction is affected by the maternal blood pressure status.Ut.DV was obtained within 7 days of delivery in 90 consecutive pregnancies with IUGR and in 37 uneventful control pregnancies. Abnormal Ut.DV was defined as an average of a (left and right systolic)/diastolic ratio >2.6 and diastolic notching. lifter delivery, pathological studies were performed with attention paid to macroscopic and microscopic evidence of hypoxic or ischaemic placental lesions related to uteroplacental vascular pathological features.In patients with IUGR, the total rate of placental lesions was significantly higher in the presence of abnormal Ut.DV compared to the presence of normal Ut.DV (relative risk, 6.35; 95 per cent confidence interval=5.2-7.3). The rate and the severity of these lesions was not significantly different between normotensive and hypertensive pregnancies (87 versus 93 per cent; P=0.2). When Ut.DV was normal, the rate of placental lesions was similar between IUGR cases and control pregnancies (14 versus 8 per cent; P=0.69). The perinatal outcome was not significantly different in any of the normotensive and the hypertensive pregnancies with growth-restricted fetuses and abnormal Ut.DV.The presence of abnormal Doppler velocimetry of the uterine arteries in pregnancies with fetal intrauterine growth restriction is may be in fact an important indicator of hypoxic or ischaemic placental lesions. This abnormal Doppler velocimetry is independent of the maternal blood pressure status. (C) 1999 W. B. Saunders Company Ltd.