在12 + 0至15 + 6周使用母体血液动力学参数预测子前期
X Wang1, D S Sahota1,2, L Wong1
1Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China.
概括
孕产妇的血液动力学变化,包括增加的全身血管抵抗和心脏输出量的减少,先于产前 (PE) 的发展. 然而,将这些血液动力学标志物添加到胎儿医学基金会 (FMF) 三重测试中并没有改善PE查性能.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 怀孕期间的心血管生理学
背景情况:
- 孕前 (PE) 是导致母亲和胎儿发病的主要原因.
- 早期发现PE风险对于及时干预至关重要.
- 孕产妇的血液动力学概况可以提供有关PE心血管适应不良的见解.
研究的目的:
- 为了比较发育PE的女性与没有发育PE的女性的母体血液动力学概况.
- 为了评估血液动力学参数的查性能,结合胎儿医学基金会 (FMF) 对PE的三重测试.
- 评估母亲血液动力学对早产和随时发作的PE的预测价值.
主要方法:
- 在怀孕11~14周之间对中国妇女进行过早性勃起检查的前性病例对照研究.
- 根据FMF三重测试结果,匹配高风险和低风险组.
- 母亲的血液动力学 (心率,中风量,心脏输出,全身血管阻力) 通过心声学评估在怀孕12~16周之间.
- 血液动力学参数分析为调整为妊娠年龄和孕产妇因素的中位数 (MoM) 的倍数.
- 选性能使用接收器运行特征曲线 (AUC) 下的面积和检测率来评估.
主要成果:
- 与未受影响怀孕相比,发育PE的女性的平均log10 SVR MoM显著更高,平均log10 SV和CO MoM较低.
- 没有观察到平均log10HR MoM的显著差异.
- 将血液动力学参数 (CO,SVR) 添加到FMF三重测试中没有显著改善早产或任何发病PE的AUC或检测率.
- 在PE病例中,血液动力学参数与分娩时的妊娠年龄没有显著的相关性.
结论:
- 升高的SVR和降低的CO是患PE的女性心血管适应不良的早期指标.
- 在怀孕早期对母亲的血液动力学评估并不能提高PE的FMF三重测试的查性能.
- 与包括母亲血液动力学在内的生物标志物组合相比,FMF三重测试仍然是PE预测的优越查工具.
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