Ultrasonography Of Uterine And Fetal Hemodynamics In Hypertensive Diseases During Pregnancy

Purpose:Objective to explore uterus arery（Uta）and fetal umbilcal artery（Uterus）during late pregnancy in pregnant women with hypertensive diseases of pregnancy（HDP）.Clinical value of ua and middle cerbral artery（mca）blood flow parameters in disease assessment and correlation of maternal and fetal pregnancy outcomes.Method:126 pregnant women with hdp were selected as research objects to obtain the restance index（RI）and pulse index（PI）of the left and right uterine arteries of the pregnant women in the third trimester.PI)value and the ratio of peak systolic velocity/end diastolic velocity（S/D）and the value of ri,pi and s/d of fetal umbilical artery and middle cerebral artery,The ratio of RI.PI.S/D of middle cerebral artery,umbilical artery and uterine artery was calculated:RIMCA/UA,PIMCA/UA,S/DMCA/UA and RIMCA/UTA,PIMCA/UTA and S/DMCA/UTA.Perinatal and maternal pregnancy outcomes were tracked.according to the severity of the disease,they were divided into gestational hypertension group,preeclampsia group and severe preeclampsia group.According to the perinatal pregnancy outcome,the perinatal infants were divided into the perinatal poor pregnancy outcome group and the perinatal good pregnancy outcome group.Parturients were divided into poor parturient pregnancy outcome group and good parturient pregnancy outcome group according to the maternal pregnancy outcome.The blood flow parameters of each group were compared.Results:1.According to the disease grouping,the resistance parameters of uterine artery and fetal umbilical artery increased with the severity of the disease,while pi_mca/utaand pi_mca/uadecreased with the severity of the disease.2.RI,PI,S/D of uterine artery and umbilical artery in perinatal adverse pregnancy outcome group were higher than those in good pregnancy outcome group,PI of middle cerebral artery in perinatal adverse pregnancy group was lower than that in good pregnancy outcome group,PI_MCA/UTA,PI_MCA/UAvalues in adverse pregnancy outcome group were lower than those in good pregnancy outcome group.3.Among different maternal pregnancy outcomes,the uterine artery RI,PI and S/D of the poor pregnancy outcome group were higher than those of the good pregnancy outcome group,and the RI_MCA/UTA,PI_MCA/UTAand S/D_MCA/UTAof the poor pregnancy outcome group were lower than those of the good pregnancy outcome group.There was statistical difference（p<0.05）.There was no significant difference in the blood flow value of middle cerebral artery（p>0.05）.4.ua-pi,uta-pi,mca-pi and their combination were used to predict the degree of hdp,perinatal adverse pregnancy outcome and maternal adverse pregnancy outcome,and combined pi had the highest auc value and the strongest sensitivity.Conclusion:The results of this study indicate that uterine artery is an important indicator of the severity of hypertensive diseases during pregnancy.Uterine artery is significant in predicting adverse pregnancy outcome.umbilical artery and uterine artery have guiding significance for predicting perinatal adverse pregnancy outcome.Combined monitoring of uterine artery,middle cerebral artery and umbilical artery has the best sensitivity to hypertensive disease and pregnancy outcome during pregnancy.