■为了检查与无并发症的正常血压妊娠相比,有或没有胎儿生长受限(FGR)的高血压妊娠中母体心血管参数的潜在变化,并确定母体心血管参数与脐和子宫动脉循环变化之间的相关性。
这项研究从妊娠20周开始招募了73名孕妇,分为三组:高血压疾病(妊娠高血压,先兆子痫或子痫,n=30),患有FGR的高血压疾病(n=8)和健康正常妊娠妇女的对照组(n=35)。所有参与者均接受超声心动图检查以评估心输出量并计算外周血管阻力。此外,对子宫和脐动脉进行胎儿生物特征测量和多普勒超声检查。结果被标准化为胎龄调整的z评分。
■子宫动脉的平均搏动指数(PI)(1.36,p<0.001)和脐动脉PIz评分(1.32,p<0.001)显示出高血压状态+FGR组的显着增加。在高血压+FGR组(-2.62,p=0.001)和高血压组(-2.49,p<0.001)中,母体心输出量z评分显著降低。高血压+FGR组(7.43,p<0.001)和高血压组(6.06,p<0.001)外周血管阻力显著升高。母体外周血管阻力与子宫动脉PI呈正相关(R2=0.172;p=0.0004),心输出量与子宫动脉PI呈负相关(R2=0.067;p=0.031)。然而,未发现母体心血管参数与脐动脉PI之间的显著相关性.
■在高血压妊娠中,母体心输出量显着降低,而外周血管阻力增加,不管FGR的存在。当高血压妊娠伴有FGR时,子宫和脐动脉PI均显着增加。母体外周血管阻力与子宫动脉PI呈正相关,以及母体心输出量与子宫动脉PI之间呈负相关。然而,母体心血管参数的变化与脐动脉PI没有显着相关性。
UNASSIGNED: To examine potential alterations in maternal cardiovascular parameters in hypertensive pregnancies with or without fetal growth restriction (FGR) in comparison to uncomplicated normotensive pregnancies, and to determine the correlation between maternal cardiovascular parameters and changes in umbilical and uterine artery circulation.
UNASSIGNED: This study enrolled 73 pregnant women starting from the 20th week of gestation, categorized into three groups: hypertensive conditions (pregnancy-induced hypertension, preeclampsia or eclampsia, n = 30), hypertensive conditions with FGR (n = 8) and a control group of healthy normotensive pregnant women (n = 35). All participants underwent echocardiography to assess cardiac output and calculate peripheral vascular resistance. Additionally, fetal biometric measurements and Doppler ultrasound examinations of the uterine and umbilical artery were performed. The results were standardized into gestational age-adjusted z-scores.
UNASSIGNED: The mean pulsatility index (PI) of the uterine artery (1.36, p < 0.001) and umbilical artery PI z-scores (1.32, p < 0.001) showed significant increases in the hypertensive conditions + FGR group. Maternal cardiac output z-scores were notably lower in both the hypertensive + FGR group (-2.62, p = 0.001) and the hypertensive group (-2.49, p < 0.001). Peripheral vascular resistance was significantly elevated in the hypertensive + FGR group (7.43, p < 0.001) and the hypertensive group (6.06, p < 0.001). There was a positive correlation between maternal peripheral vascular resistance and uterine artery PI (R2 = 0.172; p = 0.0004), and a negative correlation between cardiac output and uterine artery PI (R2 = 0.067; p = 0.031). However, significant correlation between maternal cardiovascular parameters and umbilical artery PI was not identified.
UNASSIGNED: Maternal cardiac output exhibits a significant decrease whereas peripheral vascular resistance increases in hypertensive pregnancies, irrespective of the presence of FGR. Both uterine and umbilical artery PI notably increase when hypertensive pregnancies are accompanied by FGR. A positive correlation exists between maternal peripheral vascular resistance and uterine artery PI, as well as a negative correlation between maternal cardiac output and uterine artery PI. However, changes in maternal cardiovascular parameters do not exhibit significant correlations with umbilical artery PI.