Prediction of Uterine Artery Doppler for Preeclampsia
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摘要: 子痫前期(preeclampsia)是产科严重并发症之一,基本病理生理变化是全身小血管痉挛和血管内皮损伤,全身各脏器、系统血流灌注减少,可引起母体子痫发作及重要脏器功能受损,另一方面,子宫胎盘血流灌注不足,医源性早产、胎儿窘迫、胎儿生长受限等发生风险增加,是导致孕产妇和围产儿发病及死亡的主要原因之一。目前子痫前期的防治尚未取得确切成效,一旦发生子痫前期,终止妊娠是唯一有效地治疗措施,因此,早期识别子痫前期高危患者并积极采取干预措施,有助于降低母儿不良围产结局的发生风险。目前预测子痫前期的指标主要有母体特征、血清学检查、多普勒超声等,其中母体特征主要包括子痫前期高危因素,如母体年龄、体重指数、平均动脉压、子痫前期既往史等,血清学指标包括孕中期产前筛查血清学指标,以及其他特异性血清标志物如可溶性酪氨酸激酶受体1、胎盘生长因子、妊娠相关血浆蛋白A、胎盘蛋白13等,多普勒超声包括胎儿脐动脉、大脑中动脉、静脉导管、母体子宫动脉等血流参数,以上三类指标分别可单独或联合多种指标运用于子痫前期的早期识别。多普勒超声作为一种操作简便且安全无创的检测手段,越来越为临床所重视,其中母体子宫动脉血流的多普勒超声检测对子痫前期的预测作用在多项研究中得到验证。本文旨在综述近年来子宫动脉多普勒超声在预测子痫前期中的应用,为后续的临床研究提供参考。Abstract: Preeclampsia is one of the serious obstetric complications. The basic pathophysiological changes are systemic vasospasm and vascular endothelial injury. Decreased blood perfusion of organs and systems can cause maternal eclampsia and impairment of important organ functions. On the other hand, insufficient blood perfusion of uterus and placenta, iatrogenic premature birth, fetal distress, fetal growth restriction, etc. Increased risk is one of the main causes of maternal and perinatal morbidity and mortality. At present, the prevention and treatment of preeclampsia has not yet achieved definite results. Once preeclampsia occurs, termination of pregnancy is the only effective treatment. Therefore, early identification of high-risk preeclampsia patients and active intervention measures can help reduce the risk of adverse perinatal outcomes of mothers and infants. At present, the main indicators for predicting preeclampsia include maternal characteristics, serological examination and Doppler ultrasound. The maternal characteristics mainly include high-risk factors of preeclampsia, such as maternal age, body mass index, mean arterial pressure and past history of preeclampsia. Serological indicators include triple indicators of second-trimester prenatal serum screening, as well as other specific serum markers such as soluble tyrosine kinase receptor 1, placental growth factor, pregnancy-related plasma protein A and placental protein 13. Doppler ultrasound indicators include fetal umbilical artery, middle cerebral artery, venous catheter and maternal uterine artery and other blood flow parameters. These three indicators can be used for early identification of preeclampsia alone or in combination. Doppler ultrasound, as a simple, safe and non-invasive detection method, has attracted more and more attention in clinic. The predictive effect of Doppler ultrasound on maternal uterine artery blood flow on preeclampsia has been verified in many studies. The purpose of this article is to review the application of uterine artery Doppler ultrasound in predicting preeclampsia in recent years, and to provide reference for follow-up clinical research.
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Key words:
- Uterine artery /
- Doppler ultrasound /
- Preeclampsia /
- Review
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