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目的探讨妊娠期发生脐动脉舒张末期血流缺失(absent end-diastolic velocity,AEDV)的原因及与围生儿结局的关系。方法对2009年1月至2011年12月北京大学第一医院22例AEDV母儿的临床资料进行回顾性分析,并追踪妊娠结局。结果 22例孕妇中,17例有合并症或并发症,5例无合并症或并发症。17例患者中,子痫前期13例,其中合并胎儿生长受限(FGR)5例,慢性高血压并发子痫前期1例,肾源性高血压并发子痫前期3例;单纯FGR者1例。慢性高血压合并妊娠1例;先天性心脏病(法洛四联症术后)1例;原发性抗磷脂综合征1例。双胎妊娠2例,其中选择性FGR 1例,死胎1例;胎儿畸形3例,分别为尿道下裂、房间隔缺损及染色体异常(21-三体),其中胎儿房间隔缺损孕妇合并重度子痫前期和FGR。结论以子痫前期为主的妊娠并发症是妊娠中晚期胎儿脐动脉血流缺失的主要病因。双胎妊娠中AEDV与选择性FGR有关。在无明确合并症或并发症的情况下出现AEDV应进一步寻找胎儿原因。
Objective To investigate the causes of absent end-diastolic velocity (AEDV) and its relationship with perinatal outcome in pregnancy. Methods From January 2009 to December 2011, the clinical data of 22 AEDV mothers and children in Peking University First Hospital were retrospectively analyzed and the pregnancy outcome was tracked. Results Of the 22 pregnant women, 17 had complications or complications, and 5 had no complications or complications. Of the 17 patients, 13 were preeclampsia, including 5 cases of fetal growth restriction (FGR), 1 case of chronic hypertension complicated by preeclampsia, 3 cases of nephrogenic hypertension complicated by preeclampsia, 1 case of simple FGR . 1 case of chronic hypertension complicated by pregnancy, 1 case of congenital heart disease (tetralogy of Fallot) and 1 case of primary antiphospholipid syndrome. 2 cases of twin pregnancy, including 1 case of selective FGR and 1 case of stillbirth; 3 cases of fetal malformations were hypospadias, atrial septal defect and chromosomal abnormality (21- trisomy), respectively. Among them, pregnant women with atrial septal defect Preeclampsia and FGR. Conclusion Pregnancy with preeclampsia is the main cause of fetal umbilical artery blood loss in the second trimester of pregnancy. AEDV is associated with selective FGR in twin pregnancies. AEDV should be further searched for fetal causes in the absence of a definite complication or complication.