| Objective:Pregnancy complications such as hypertension during pregnancy and fetal growth restriction have always seriously threatened the safety of mother and baby.Uterine artery doppler is a noninvasive procedure used to assess maternal and fetal circulation in order to predict pregnancy complications.The sensitivity of uterine artery doppler alone to predict pregnancy complications was moderate.By comparing analysis of pregnant women characteristics(age,body mass index,maternal history),uterine artery doppler spectrum and biochemical indices abnormal early pregnancy and the correlation of pregnancy complications,selected risk factors associated with pregnancy complications,scoring system to establish mother characteristics,risk factors and the joint,raise their sensitivity to predict pregnancy complications.In order to achieve early prediction and early intervention.Methods:A total of 158 pregnant women who underwent antenatal examination and delivered in the second affiliated hospital of a medical university from January to December 2019 were selected.Collection of pregnant women characteristics,including age,body mass index(BMI),maternal history,in the early pregnant women pregnant(<9 weeks)recorded when the common biochemical indexes,including hemoglobin concentration,promote thyroxine(TSH),D-dimer value.and then in the pregnant women pregnant<9 weeks,11 to 13 weeks+6 days,22 and 23 weeks+6 days,27 to 28 weeks+6 days respectively with ultrasound to collect its bilateral uterine artery blood flow parameters(PS,RI,PI,SID),and records the bilateral uterine artery diastolic blood flow with and without early incisure and regurgitation.Regular follow-up was conducted to record the occurrence of common pregnancy complications:gestational hypertension,gestational diabetes,fetal growth restriction(FGR),oligohydramnios,stillbirth.The risk factors related to pregnancy complications were analyzed,and the mother scoring system was established.Results:1.Among the 158 pregnant women examined and followed up to delivery in our hospital in one year,112(71%)had normal pregnancy outcomes,46(29%)had gestational hypertension,gestational diabetes.FGR,and oligohydramnios,and none of these 158 pregnant women had stillbirths.2.Among maternal characteristics,there was no significant correlation between the pregnant woman’s BMI,gestational frequency and birth frequency and the occurrence of pregnancy complications,and the difference was not statistically significant.The age of pregnant women was significantly correlated with the occurrence of pregnancy complications,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that age was an influential factor in the occurrence of pregnancy complications.Compared with pregnant women aged<35 years old,pregnant women aged>35 years old had a 1.73 times higher risk of pregnancy complications than pregnant women aged<35 years old.3.Among the serological parameters of pregnant women,abnormal TSH value at pregnancy<9 weeks was significantly correlated with the occurrence of pregnancy complications,and the difference was statistically significant(P<0.05).D-dimer value and abnormal hemoglobin at<9 weeks were not significantly correlated with the occurrence of pregnancy complications,and the difference was not statistically significant(P>0.05)4.Among the doppler parameters of uterine artery blood flow in pregnant women at each period,the PI and RI values at 22-23+6 weeks+6 days were significantly correlated with the occurrence of pregnancy complications,with statistically significant differences(P<0.05),while PS and S/D values were not statistically significant(P>0.05).However,the doppler parameters of uterine artery blood flow<9 weeks,11-13 weeks+6 days,27-28 weeks+6 days had no significant correlation with the occurrence of pregnancy complications(P>0.05).By chi-square test,found that pregnant women at 22 and 23 weeks+6 days of uterine artery incisure is significantly associated with pregnancy complications,the difference is statistically significant(P<0.05),pregnancy<9 weeks,11 to 13 weeks+6 days.27 to 28 weeks of incisure+6 days uterine arteries had no significant correlation with the incidence of pregnancy complications,there was no statistically significant difference(P>0.05).5.Among the risk factors of uterine artery doppler flow,the sensitivity of uterine artery PI to predict pregnancy complications was 65.05%,the specificity was 88.24%,and the Jordan index was 0.5329.The sensitivity and specificity of RI in predicting pregnancy complications were 71.58%,90.24%and 0.6182 respectively.The sensitivity.specificity and Jordan index of uterine artery blood flow trace to predict pregnancy complications were 47.37%,86.91%and 0.3428 respectively.6.Maternal scoring system had statistical significance in predicting pregnancy complications;The maternal scoring system is based on the age of the pregnant woman and the presence or absence of abnormal thyroid function in early pregnancy.(1)the pregnant woman is older than or equal to 35 years old,1 point;Less than 35 years old,rating 0;(2)evaluation of thyroid dysfunction in early pregnancy 1 point;There was no abnormal thyroid function in early pregnancy.When the maternal score was≥1,the sensitivity of the prediction of pregnancy complications was 61.31%,the specificity was 72.34%,and the Jordan index was 0.3365.When maternal score=2,the sensitivity and specificity of the prediction of pregnancy complications were 69.84%.74.66%and 0.4450 respectively.7.At 22-23 weeks+6 days gestation,the risk factors of uterine arterial blood flow doppler(PI,RI and early diastolic incision)combined with the maternal scoring system were 83.84%sensitive,91.66%specific and 0.7550 yoden index in predicting pregnancy complications.Conclusion(s):1.Among maternal characteristics,the age of pregnant women is significantly correlated with the occurrence of pregnancy complications,while the BMI,gestational rate and birth rate of pregnant women are not significantly correlated with the occurrence of pregnancy complications.2.Among the serological indicators of pregnant women,abnormal TSH value at<9 weeks was significantly correlated with the occurrence of pregnancy complications,while abnormal hemoglobin concentration and d-dimer value at<9 weeks were not significantly correlated with the occurrence of pregnancy complications.3.Among the doppler parameters of uterine artery blood flow,the PI and RI values at 22-23 weeks+6 days after pregnancy and the existence of early uterine artery blood flow diastole were significantly correlated with the occurrence of pregnancy complications.4.The combination of uterine artery PI,RI and notch at 22-23 weeks+6 days of gestation with the maternal scoring system(score≥1)improved the sensitivity and specificity of predicting pregnancy complications. |
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