Characteristics of midluteal phase uterine artery hemodynamics in patients with recurrent pregnancy loss
Characteristics of midluteal phase uterine artery hemodynamics in patients with recurrent pregnancy loss
复制标题
复发性流产患者黄体中期子宫动脉血流动力学特征
DOI：
10.1111/jog.13944
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发表时间：
2019-07-01
影响因子：
1.6
通讯作者：
Kang, Xiaomin
中科院分区：
文献类型：
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作者：
Yang, Wen;Wu, Ze;Kang, Xiaomin
目的探讨子宫动脉血流阻力与复发性妊娠丢失（RPL）的关系及其潜在影响因素。方法回顾性分析2014年1月至2018年2月在我院就诊的870例RPL患者和237例非RPL患者。所有受试者均接受全面检查，并于黄体中期进行经阴道多普勒超声扫描，测量左、右子宫主动脉搏动指数（PI）、阻力指数（RI）和收缩/舒张比值（S/D）。P值小于0.05被认为具有统计学显著性。结果RPL组子宫动脉PI、RI、S/D值均显著高于非RPL组（P < 0.001）。当受试者根据RPL的不同病因分组时，发现抗磷脂综合征的RPL患者的子宫动脉指数显着较高（P < 0.001），自身免疫性疾病内分泌异常（P <0.05）、血栓形成倾向（P <0.001）、子宫异常（P <0.01）和原因不明的RPL（P < 0.001）。染色体异常组与子宫动脉血流无显著性差异（P > 0.05）。RPL组的平均PI、平均RI和平均S/D值无显著性差异（P > 0.05）。年龄、自然流产次数两组比较差异无统计学意义（P > 0.05）.结论子宫动脉血流灌注异常可能是RPL的潜在病理基础，可作为妊娠失败的独立危险因素。
Aim To study the association in resistance to uterine artery blood flow and recurrent pregnancy loss (RPL) and find its potential influencing factors. Methods A retrospective study was conducted in 870 RPL and 237 non-RPL patients visiting to the Clinic from January 2014 to February 2018. All participants underwent comprehensive examinations and were scanned by transvaginal Doppler ultrasonography during the midluteal phase to measure the pulsatility index (PI), resistance index (RI) and systolic/diastolic ratio (S/D) values of the left and right main uterine arteries. P value less than 0.05 was considered statistically significant. Results The mean PI, RI and S/D values for uterine arteries were significantly higher in RPL patients than in non-RPL patients (P < 0.001). When subjects were grouped according to the different etiologies of RPL, significant higher indices of uterine arteries were found in RPL patients with antiphospholipid syndrome (P < 0.001), autoimmune diseases (P < 0.001), endocrinological abnormalities (P < 0.05), thrombophilia (P < 0.001), uterine anomalies (P < 0.01) and unexplained RPL (P < 0.001). No differences were found between patients with chromosomal anomalies and uterine arteries blood flow (P > 0.05). In RPL patients, mean PI, mean RI and mean S/D values shows no difference among groups (P > 0.05). The Similar results were observed in age and number of spontaneous abortion (P > 0.05). Conclusion Impaired uterine artery blood perfusion may be an underlying pathology to RPL, and it can be used as an independent risk factor for pregnancy failure.