Clinical value of monitoring the spiral artery blood flow in patients with early threatened abortion by color Doppler ultrasound

Shufan Cui
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Abstract

Objective To investigate the clinical value of color Doppler ultrasonography in monitoring the uterine spiral artery blood flow in patients with early threatened abortion. Methods A total of 360 women with threatened abortion in the early 5-8 weeks of pregnancy treated in Taihang Hospital from June 2017 to June 2019 were selected as the study group. And another 100 healthy women with early pregnancy in the same period were selected as control group. All the pregnant women were examined by abdominal color Doppler ultrasound. The index of uterine spiral artery blood flow resistance indexes, including pulsation index, peak systolic velocity and end-diastolic velocity, were measured and compared. Results ①There was no significant difference in comparison on peak systolic velocity between the study group and control group, which was (44.89±2.45)cm/s vs. (44.35±3.18)cm/s (t=1.573, P=0.058). The end-diastolic velocity of the study group was (7.45±1.26)cm/s, lower than the (9.31±1.15)cm/s of the control group, and the resistance index (2.67±0.42) and pulse index (0.91±0.15) were higher than those of the control group (1.75±0.28, 0.72±0.09), t=14.006, 25.775, 15.861, all P<0.01. ②There was no significant difference in peak systolic velocity between successful and unsuccessful foetus protectors, (44.34±3.84)cm/s vs. (44.82±2.65)cm/s, t=0.812, P=0.209. The end-diastolic velocity of successful foetus protectors was (9.06±1.42) cm/s, higher than the (7.06±1.33) cm/s of the unsuccessful foetus protectors, while the resistance index (1.99±0.35) and the pulse index (0.82±0.19) were lower than those of the unsuccessful foetus protectors (2.98±0.41, 0.91±0.13), t=6.947, 11.728, 3.102, all P<0.01. ③There were no statistically significant differences in systolic peak and end-diastolic velocities between the successful foetus survivors in the study group and in the control group (t=0.423, 1.804, P=0.336, 0.056), while the resistance index (1.99±0.35) and pulse index (0.82±0.19) were higher than those in the control group (1.75±0.28, 0.72±0.09), t=7.085, 7.291, both P<0.01. ④The systolic peak velocity of women with miscarriage in the study group was (44.82±2.65)cm/s, which was not significant different from the (44.18±3.15)cm/s in the control group (t=1.006, P=0.158). While the end-diastolic velocity in with miscarriage in the study group was (7.06±1.33)cm/s, lower than the (9.31±1.15)cm/s in the control group (t=7.494, P<0.01). And women with miscarriage in the study group had higher resistance index (2.98±0.41) and pulse index (0.91±0.13) than the control group (1.75±0.28, 0.72±0.09), t=13.673, 6.652, both P<0.01. Conclusions Color Doppler ultrasound monitoring the uterine spiral artery blood flow indicators in patients with early threatened abortion is of great clinical significance, and plays a positive role in predicting the prognosis of patients and reasonably guiding the fetal care treatment program. Key words: Color Doppler monitoring; Early threatened abortion; Blood flow index of uterine spiral artery; Prediction; Foetus protection treatment
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彩色多普勒超声监测早期先兆流产患者螺旋动脉血流的临床价值
目的探讨彩色多普勒超声监测早期先兆流产患者子宫螺旋动脉血流的临床价值。方法选择2017年6月~ 2019年6月在太行医院就诊的孕早期5 ~ 8周先兆流产孕妇360例为研究组。另外选取同期健康早孕妇女100名作为对照组。所有孕妇均行腹部彩色多普勒超声检查。测定并比较子宫螺旋动脉搏动指数、收缩峰值速度、舒张末期速度等血流阻力指标。结果①研究组与对照组的最大收缩期速度分别为(44.89±2.45)cm/s和(44.35±3.18)cm/s,差异无统计学意义(t=1.573, P=0.058)。研究组舒张末期速度为(7.45±1.26)cm/s,低于对照组(9.31±1.15)cm/s,阻力指数(2.67±0.42)、脉搏指数(0.91±0.15)高于对照组(1.75±0.28、0.72±0.09),t=14.006、25.775、15.861,P均<0.01。②保护剂成功组与未成功组的最大收缩速度(44.34±3.84)cm/s vs(44.82±2.65)cm/s,差异无统计学意义,t=0.812, P=0.209。保胎成功组舒张末期流速为(9.06±1.42)cm/s,高于不成功组(7.06±1.33)cm/s,阻力指数(1.99±0.35)、脉搏指数(0.82±0.19)低于不成功组(2.98±0.41、0.91±0.13),t=6.947、11.728、3.102,P均<0.01。③研究组存活胎儿的收缩压峰值和舒张末期速度与对照组比较差异无统计学意义(t=0.423, 1.804, P=0.336, 0.056),而阻力指数(1.99±0.35)和脉搏指数(0.82±0.19)高于对照组(1.75±0.28,0.72±0.09),t=7.085, 7.291, P均<0.01。④研究组流产妇女的收缩峰值流速为(44.82±2.65)cm/s,与对照组的(44.18±3.15)cm/s差异无统计学意义(t=1.006, P=0.158)。研究组合并流产时舒张末流速为(7.06±1.33)cm/s,低于对照组(9.31±1.15)cm/s (t=7.494, P<0.01)。研究组流产妇女阻力指数(2.98±0.41)、脉搏指数(0.91±0.13)高于对照组(1.75±0.28、0.72±0.09),t=13.673、6.652,P均<0.01。结论彩色多普勒超声监测早期先兆流产患者子宫螺旋动脉血流指标具有重要的临床意义,对预测患者预后、合理指导胎儿护理治疗方案具有积极作用。关键词:彩色多普勒监测;早期先兆流产;子宫螺旋动脉血流指数;预测;胎儿保护治疗
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