The predictive value of uterine artery ultrasound examination during early pregnancy for gestational hypertension / 中国基层医药

ABSTRACT

Objective:To analyze the predictive value of uterine artery ultrasound examination during early pregnancy for gestational hypertension.Methods:A total of 100 patients with gestational hypertension who received treatment in Jinhua Maternal and Child Health Hospital from January 2020 to January 2022 were included in the observation group. An additional 100 healthy pregnant women who concurrently underwent routine physical examination were included in the control group. Using the case-control study method, both groups underwent uterine artery ultrasound examination during early (7-11 gestational weeks and 6 days) pregnancy. Uterine artery ultrasound data [resistance index (RI), pulsatility index (PI), and arterial peak systolic/diastolic flow velocity (S/D)] were determined and compared between the two groups. Patients in the observation group were followed up to delivery, and the adverse maternal and infant outcomes were analyzed. Those with adverse maternal and infant outcomes were included in the poor prognosis group, while those without adverse maternal and infant outcomes were included in the good prognosis group. The ultrasound data of uterine arteries were compared between the two groups. Logistic regression analysis was performed to analyze the correlation between uterine artery ultrasound data and adverse maternal and infant outcomes.Results:The RI, PI, and S/D of pregnant women in the observation group were (0.56 ± 0.15), (1.29 ± 0.34), (3.79 ± 0.32), respectively, which were significantly greater than (0.41 ± 0.12), (0.72 ± 0.21), (2.88 ± 0.25) in the control group ( t = 7.80, 14.26, 22.40, all P < 0.001). In the observation group, there were 11 cases of premature birth, 2 cases of miscarriage, 4 cases of postpartum hemorrhage, 4 cases of premature rupture of amniotic fluid, 5 cases of fetal distress, 3 cases of neonatal asphyxia, and 1 case of neonatal growth restriction. The total incidence of adverse maternal and infant outcomes was 30.0% (30/100). The RI, PI, and S/D of pregnant women in the poor prognosis group were (0.65 ± 0.19), (1.37 ± 0.40), and (4.06 ± 0.37), respectively, which were significantly higher than (0.50 ± 0.13), (1.16 ± 0.31), and (3.35 ± 0.29) in the good prognosis group ( t = 4.57, 2.83, 10.30, all P < 0.05). Logistic regression analysis was performed using adverse maternal and infant outcomes as dependent variables and RI, PI, and S/D as independent variables. Logistic regression analysis results showed that RI, PI, and S/D were the risk factors for adverse maternal and infant outcomes ( OR = 2.760, 1.832, 3.241, 95% CI = 1.209-5.985, 1.001-2.971, 2.134-10.159). Conclusion:Uterine artery ultrasound examination during early pregnancy has a certain reference value for predicting gestational hypertension and evaluating adverse maternal and infant outcomes. It can provide a reliable basis for early diagnosis and treatment of gestational hypertension and is beneficial for patient prognosis.