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。

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.

目的 本研究的目的在于通过非孕期与孕期妇女行胎儿纤维连接蛋白的检测对比,再次认识胎儿纤维连接蛋白在早产预测中的价值,是否能有效的预测早产。方法 通过对180例非孕妇女行fFN检测,同时进行白带感染方面的检测,从而判断两者是否具有相关性,同时通过对150例中晚孕妇女于20～34周行fFN检测,判断其在预测早产发生方面的临床应用价值。结果 在180例非孕妇女,发生生殖道感染的患者fFN阳性率增高,与fFN阴性者有差异;在150例中晚孕妇女当中,患者于7天内分娩的敏感度,特异度,阳性预测价值,阴性预测价值为85.7%,69.33%,13.33%,99%。14天内分娩的敏感度,特异度,阳性预测价值,阴性预测价值为80％,68.67%,17.78%,99%。结论 由于 fFN检测易受生殖道感染及其他多种因素干扰,故其在早产预测中的准确性有限。