The Role Of Uterine Artery Flow Resistance Testing In Early Pregnancy In Screening For Miscarriage Related Factors

Background and purpose of the study: Maternal-fetal circulation is assessed by color Doppler ultrasound monitoring of uterine artery flow resistance in early pregnancy to identify women with risk pregnancies who may be exposed to complications and undesirable gestational outcomes for the purpose of enabling premature prediction and early intervention.Methods: Ninety-eight women in early pregnancy attending the Reproduction Centre of The First Affiliated Hospital of Dalian Medical University from September 2019 to May 2022 were retrospectively collected,and their uterine artery flow resistance parameters(S/D,RI,PI)were collected at each gestational week from 5 to 12 weeks of gestation,and the presence or absence of bilateral uterine artery tangents in early diastole was recorded.The presence or absence of pregnancy complications during pregnancy,including hypertensive disorders of pregnancy(HDP),fetal growth restriction(FGR),gestational diabetes mellitus(GDM)and amniotic fluid,and the presence or absence of adverse pregnancy outcomes such as miscarriage,preterm delivery,and small for gestational age(SGA),will be recorded.The following are some of the most common causes of pregnancy loss To analyse whether there is a correlation between uterine artery flow in early pregnancy and risk factors for miscarriage such as coagulation status and immune antibodies,as well as pregnancy outcomes following early treatment when increased uterine artery resistance,thrombus-prone status and immune abnormalities are detected in early pregnancy.Results: 1.Uterine blood flow parameters S/D,PI and RI in pregnant women in early pregnancy gradually decreased with increasing gestational weeks.2.The uterine artery blood flow resistance was divided into a high-resistance group and a normal-resistance group according to the level of resistance at week 5-6 of pregnancy.The prevalence of a history of ≥2 miscarriages,positive a PLs,and thrombus-prone status(including abnormal coagulation parameters such as D-D, thromboelastography,and platelet aggregation rate)was significantly higher in the high-resistance group compared with the normal resistance group(P<0.05).3.In patients with immune abnormalities and thrombophilia who were treated with aspirin or low molecular heparin before or during the early stages of pregnancy(week5-6),the uterine artery flow parameters S/D,PI and RI were significantly higher in the high resistance group compared to the normal resistance group during week 5-9 of pregnancy(P<0.05);however,from week 10 onwards,there was no There was no significant difference between the two groups from the 10 th week of pregnancy.4.Screening for coagulation parameters and immune antibodies was performed in patients who had no abnormalities before pregnancy and who developed increased uterine artery resistance after pregnancy,and a significantly higher prevalence of a PLs positive,ANA positive and thrombus prone status was found in this group.5.D-dimer and platelet aggregation rates were significantly higher in the high-resistance group compared to the normal group,regardless of whether aspirin intervention was given prior to pregnancy(P<0.05);thromboelastograms including R-values,MA-values and K-values were not significantly different between the two groups.6.All patients were grouped according to the presence or absence of coagulation indicators.The uterine arterial flow resistance parameters S/D,PI and RI values were significantly higher in the group with abnormal coagulation compared to the group with normal coagulation(P<0.05).7.The incidence of pregnancy outcomes including GDM,HDP,FGR,hypohydramnios,miscarriage,preterm delivery and SGA were not significantly abnormal in the high-resistance arterial flow group after the intervention compared to the normal resistance group.The miscarriage rate in the high resistance group was6.12%.The normal resistance miscarriage rate was 8.16%,all within the range of normal population miscarriage rates.Conclusion: 1.The resistance to uterine artery flow in early pregnancy gradually decreases with increasing gestational weeks.2.Increased uterine artery flow resistance in early pregnancy suggests that the mother may have abnormal coagulation indicators and be in an abnormal state;further testing for immune-related indicators when the two coexist makes it easier to detect abortion-associated antibodies.3.Based on the results of early pregnancy uterine artery flow resistance,coagulation and immunological markers,timely and appropriate treatment can be given to guide subsequent management to avoid pregnancy complications and adverse outcomes.4.The detection of uterine artery resistance in early pregnancy may be a safe,non-invasive and effective screening method for miscarriage related factors.