妊娠早期低血压与子宫动脉血流的关系

doi:10.3969/j.issn.1000-8535.2021.06.003

广州医药 ›› 2021, Vol. 52 ›› Issue (6): 10-13.DOI: 10.3969/j.issn.1000-8535.2021.06.003

妊娠早期低血压与子宫动脉血流的关系

郭蓝蓝, 蒋艳敏, 王海玉, 张学真, 董涛威, 邓雯锋, 刘慧姝

广州市妇女儿童医疗中心,广州医科大学(广州 511436)

收稿日期:2021-05-26 出版日期:2021-11-20 发布日期:2021-11-26
通讯作者: 刘慧姝,E-mail:weslanlan@163.com

Relationship between early pregnancy hypotension and uterine artery blood flow

GUO Lanlan, JIANG Yanmin, WANG Haiyu, ZHANG Xuezhen, DONG Taowei, DENG Wenfeng, LIU Huishu

Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangzhou 511436,China

Received:2021-05-26 Online:2021-11-20 Published:2021-11-26

摘要/Abstract

摘要： 目的研究妊娠早期低血压对子宫动脉血流的影响。方法前瞻性连续收集2020年9月—2021年3月在广州市妇女儿童医疗中心行产前检查的早孕期正常单胎妊娠孕妇,分为两组:低血压组(43人)及正常血压组(73人),分别监测两组孕妇的双侧子宫动脉血流搏动指数 (pulse index,PI)及收缩期峰值 (peak systolic velocity,PSV),并比较两组间PI及PSV是否有统计学差异。结果双侧子宫动脉血流PI与平均动脉压呈线性正相关关系(P＜0.05)。低血压组双侧子宫动脉PI低于正常血压组,差异有统计学意义(P＜0.05),低血压组右侧子宫动脉PSV低于正常血压组,差异有统计学意义(P＜0.05),左侧子宫动脉PSV两组间无差异(P＞0.05)。结论低血压孕妇子宫动脉血流动力学参数异常降低,临床应重视妊娠期低血压孕妇子宫动脉血流动力学异常者的围产期管理。

关键词: 妊娠早期, 低血压, 子宫动脉血流

Abstract: Objective To study the relationship between early pregnancy hypotension and uterine artery blood flow. Methods We prospectively and consecutively selected pregnant women with normal singleton pregnancy in early pregnancy for this study from September 2020 to March 2021 in Guangzhou Women and Children's Medical Center. According to the blood pressure, they were divided into hypotension group (n=43) and normal blood pressure group (n=73). We monitored the pulse index (PI) and peak systolic velocity (PSV) of bilateral uterine artery blood flow, then compared the PI and PSV between the two groups. Results There was a positive linear correlation between PI and mean arterial pressure (P＜0.05). The PI of bilateral uterine arteries in hypotension group was lower than that in normal blood pressure group (P＜0.05). PSV of right uterine artery in hypotension group was lower than that in normal blood pressure group (P＜0.05). PSV of left uterine artery in hypotension group was not different from that in normal blood pressure group (P＞0.05). Conclusion Uterine artery hemodynamic parameters of hypotensive pregnant women decreased abnormally, so attention should be paid to the perinatal management of pregnant women with abnormal uterine artery hemodynamics.

Key words: early pregnancy, hypotension, uterine artery flow

郭蓝蓝, 蒋艳敏, 王海玉, 张学真, 董涛威, 邓雯锋, 刘慧姝. 妊娠早期低血压与子宫动脉血流的关系[J]. 广州医药, 2021, 52(6): 10-13.

GUO Lanlan, JIANG Yanmin, WANG Haiyu, ZHANG Xuezhen, DONG Taowei, DENG Wenfeng, LIU Huishu. Relationship between early pregnancy hypotension and uterine artery blood flow[J]. Guangzhou Medical Journal, 2021, 52(6): 10-13.

参考文献

[1] HOHMANN M, KÜNZEL W. Low blood pressure in pregnancy [J]. Z Geburtshilfe Neonatol, 2007, 211(2):45-53.
[2] WARLAND J, MCCUTCHEON H, BAGHURST P. Maternal blood pressure in pregnancy and stillbirth: a case-control study of third-trimester stillbirth[J]. Am J Perinatol, 2008, 25(5):311-317.
[3] SCHELER C, WORASCHK H J. Blood flow in the umbilical artery in maternal hypotonia[J]. Ultraschall Med, 1993, 14(1):16-22.
[4] GRÜNBERGER W, LEODOLTER S, PARSCHALK O, et al. Pregnancy hypotension and fetal outcome [J]. Fortschr Med, 1979, 97(4):141-144.
[5] CINDROVA-DAVIES T, HERRERA E A, NIU Y, et al. Reduced cystathionine gamma-lyase and increased miR-21 expression are associated with increased vascular resistance in growth-restricted pregnancies: hydrogen sulfide as a placental vasodilator [J]. Am J Pathol, 2013, 182(4):1448-1458.
[6] GOESCHN K, SCHMOLDT V, PLUTA M, et al. The effect of low blood pressure on venous function during and outside of pregnancy and therapeutic consequences[J]. Geburtshilfe Frauenheilkd, 1985, 45(8):525-533.
[7] 林建华,梁阿娟,林其德,等. 正常妊娠和妊娠期高血压疾病孕妇子宫动脉及其胎儿脐动脉血流动态变化规律的多中心研究[J]. 中华妇产科杂志,2010,45(8):583-587.
[8] FERRAZZI E, STAMPALIJA T, MONASTA L, et al. Maternal hemodynamics: a method to classify hypertensive disorders of pregnancy[J]. Am J Obstet Gynecol, 2018, 218(1): 124.e1-124.e11.
[9] GASIOROWSKA A, ZAWIEJSKA A, DYDOWICZ P, et al. Maternal factors, ultrasound and placental function parameters in early pregnancy as predictors of birth weight in low-risk populations and among patients with pre-gestational diabetes[J]. Ginekol Pol, 2019, 90(7):388-395.
[10] HESSAMI K, KASRAEIAN M, ASADI N, et al. Association of maternal and umbilical cord blood lipid parameters with uterine and fetal-placental blood flow in hypertensive and normotensive pregnancies[J]. Int J Womens Health,2020(12):115-125.
[11] MANNINEN T, AANTAA R, SALONEN M, et al. A comparison of the hemodynamic effects of paracervical block and epidural anesthesia for labor analgesia [J]. Acta Anaesthesiol Scand, 2000, 44(4):441-445.
[12] 曹瑞文. 子宫动脉血流频谱在早期妊娠子痫前期高风险人群中的筛查效果及价值研究[J]. 现代医用影像学,2020,29(8):1474-1476.
[13] JOYNER M J, BARNES J N, HART E C, et al. Neural control of the circulation: how sex and age differences interact in humans [J]. Compr Physiol, 2015, 5(1):193-215.
[14] CHARKOUDIAN N, HART E C J, BARNES J N, et al. Autonomic control of body temperature and blood pressure: influences of female sex hormones[J]. Clin Auton Res, 2017, 27(3):149-155.
[15] WOWERN E V, ANDERSSON J, SKARPING I D, et al. Association between uterine artery Doppler blood flow changes and arterial wall elasticity in pregnant women[J]. J Matern Fetal Neonatal Med, 2017,30(19):2309-2314.
[16] KHANNA V A, CHIDAMBARAM S, GOH E L. Prehospital advanced life support for out-of-hospital cardiac arrest in blunt trauma patients[J]. JAMA Surg, 2019, 154(1):95-96.

妊娠早期低血压与子宫动脉血流的关系

Relationship between early pregnancy hypotension and uterine artery blood flow

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