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目的研究孕早中期正常妊娠和子痫前期患者胎盘血流灌注情况。方法选择2008年2月至2010年8月在我院行产前检查的2000例孕妇作为研究对象。在孕11-14周和孕22-24周采用彩色多普勒超声检测子宫动脉搏动指数,根据其妊娠结局分为正常妊娠组、子痫前期组、妊娠期高血压组。结果正常妊娠组、妊娠期高血压组及子痫前期组子宫动脉搏动指数在妊娠中期均低于妊娠早期。子痫前期组孕11-14w、孕22-24w时子宫动脉PI明显高于正常妊娠组和妊娠期高血压组,而妊娠期高血压组与正常妊娠组比较,差异无统计学意义。结论正常妊娠时,随妊娠进展,子宫动脉搏动指数逐渐减低,反应子宫胎盘血流供应逐渐增加;子痫前期患者在孕早期已存在子宫胎盘血流供应障碍,导致胎盘出现缺血缺氧。子痫前期患者子宫动脉PI的改变在临床诊断之前出现,对于早期预测子痫前期的发生具有重要意义。
Objective To study the placental perfusion in normal pregnancy and preeclampsia during early pregnancy. Methods From 2000 February to 2010 August in our hospital prenatal examination of 2000 pregnant women as the research object. Pregnancy 11-14 weeks and 22-22 weeks of pregnancy by color Doppler ultrasound detection of uterine artery pulsatility index, according to their pregnancy outcome is divided into normal pregnancy group, preeclampsia group, gestational hypertension group. Results In the normal pregnancy group, the gestational hypertension group and the preeclampsia group, the uterine artery pulsatility index was lower in the second trimester than in the first trimester. In preeclampsia group, the PI of uterine artery was significantly higher than that of normal pregnancy group and gestational hypertension group at 11-14 w of pregnancy and 22-24 w of pregnancy, while there was no significant difference between gestational hypertension group and normal pregnancy group. Conclusion In normal pregnancy, with the progress of pregnancy, the pulsatility index of uterine artery gradually decreases and the supply of uterine placental blood flow gradually increases. In the first trimester of pregnancy, there is dysplasia of uterine placenta blood flow, resulting in placental ischemia and hypoxia. Changes in uterine artery PI in patients with preeclampsia appear before clinical diagnosis, which is of great significance for the early prediction of the occurrence of preeclampsia.