| BackgroundAs a kind of hypertensive disorder in pregnancy,preeclampsia is an important reason for the high morbidity and mortality of pregnant women and perinatal children.Timely monitoring and early intervention of preeclampsia patients and fetus is an important means to improve the pregnancy outcome of patients with preeclampsia.Color Doppler ultrasonography has become the main non-invasive prenatal diagnosis of hemodynamic examination.At present,ultrasound blood flow monitoring for preeclampsia mostly focuses on the blood flow status of single or two blood vesselswhile less research is performed on arterial and venous vessels simultaneously.In this study,color Doppler ultrasound was used to simultaneously monitor changes in the blood flow spectrum of the arteries and veins,and an ultrasound comprehensive scoring method was established to comprehensively analyze the relationship with preeclampsia and perinatal prognosis.ObjectiveTo explore the relationship between hemodynamic parameters and spectrum changes of maternal uterine artery(UtA),umbilical artery(UA),umbilical vein(UV),ductus venosus(DV)and middle cerebral artery(MCA)and preeclampsia and perinatal outcome.MethodsA total of 162 pregnant women with single pregnancies were selected as the study subjects,and 100 normal pregnant women with single pregnancy were used as the control group.Doppler ultrasound was used to monitor the hemodynamic changes of maternal UtA and fetal UA,MCA,DV,and UV.The outcomes of perinatal preeclampsia were followed up and recorded.The blood flow parameters and blood flow spectrum of 115 perinatal infants with poor outcomes and 47 well-prepared perinatal infants were compared.According to the prediction boundary value of each blood flow parameter and the abnormality of blood flow spectrum,a color Doppler ultrasound comprehensive scoring system was established.Results1.The incidence of abnormal blood flow spectrum in the preeclampsia group was significantly higher than that in the control group(P<0.05).Compared with the control group,the blood flow parameters of UtA,UA,DV and UV in the preeclamptic group were significantly increased,while the blood flow parameters of MCA were significantly decreased(P<0.05).The blood flow parameters of UtA,UA,DV and UV diagnose the area under the ROC curve of preeclampsia are greater than 0.6;UtA-S/D,UtA-PI,UA-PI,MCA-RI,and Qdv/Quv were independent risk factors for preeclampsia(P<0.05).2.Compared with the perinatal infants with good outcomes,the blood flow parameters of UtA,UA,DV and UV in the adverse outcome group were significantly increased,while the blood flow parameters of MCA were significantly decreased(P<0.05).The blood flow parameters of UtA,UA,DV and UV diagnose the area under the ROC curve of preeclampsia more than 0.7;The incidence of abnormal blood flow frequency in the perinatal adverse outcome group was significantly higher than that in the good outcome group(P<0.05).UtA-S/D,UtA-PI,UA-S/D,UA-RI,MCA-S/D,DV-PVIV,Qdv/Quv,bilateral uterine artery diastolic early notch are all affecting preeclampsia perinatal Independent risk factors for outcome(P<0.05).3.Compared with the good outcome group,the ultrasound composite score of perinatal infants in the adverse outcome group was significantly increased(P<0.05);The area under the curve of the ROC curve for predicting the adverse outcome of perinatal perinatal infants by ultrasound comprehensive scoring method was 0.913,and the best predictive cutoff value was 7 points.Ultrasound comprehensive scoring method is the best predictive value for predicting adverse outcomes in perinatal perinatal infants.ConclusionDoppler hemodynamic parameters of maternal UtA,fetal UA,MCA,DV and UV have high predictive value for preeclampsia and perinatal prognosis.The diagnostic value of the ultrasound comprehensive scoring method is better than the single parameter,which can more accurately predict the adverse outcome of perinatal perinatal infants,and has higher application value for improving pregnancy outcome and reducing perinatal mortality. |
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