妊娠晚期子宫动脉多普勒用于预测晚期小而适合孕龄胎儿的不良结局。

IF 1.6 Q3 OBSTETRICS & GYNECOLOGY
Minerva obstetrics and gynecology Pub Date : 2023-10-01 Epub Date: 2023-03-21 DOI:10.23736/S2724-606X.23.05229-6
Cristina Mula, Judit Hidalgo, Anna Peguero, Edurne Mazarico, Judit Martinez, Francesc Figueras, Eva Meler
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引用次数: 0

摘要

胎儿生长受限包括所有由于胎盘功能不全而没有达到自身生长潜力的胎儿,因此围产期不良后果的风险更高。对这些胎儿的识别和随访对于降低这种额外的风险至关重要。尽管第三个百分位数以下的估计胎儿体重和病理性脑胎盘比率是最可接受的预测标准,但一些证据表明,在诊断时,异常的子宫动脉多普勒可能是晚发性生长受限胎儿的有用预后参数。然而,它作为一个独立参数的预测能力是有限的。在这种情况下,包括子宫多普勒在内的生物特征和血液动力学超声参数的综合模型已被认为是对风险进行分层和改善围产期结果的有效方法。此外,还描述了子宫动脉多普勒异常与血管阻塞导致胎盘灌注不足的组织学表现之间的关系。最后,也有人提出,在孕晚期对适合胎龄胎儿的子宫动脉多普勒进行评估,可以确定亚临床胎盘功能不全的病例,但还需要进一步的证据来确定这种预测策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Third-trimester uterine artery Doppler for prediction of adverse outcome in late small-and adequate for-gestational-age fetuses.

Fetal growth restriction includes all those fetuses that do not reach their own growth potential due to placental insufficiency and therefore at higher risk of adverse perinatal outcomes. Identification and follow-up of these fetuses is essential to decrease this additional risk. Although estimated fetal weight under the 3rd centile and pathological cerebroplacental ratio are the most accepted predictive criteria, some evidence suggests that abnormal uterine artery Doppler may be a useful prognostic parameter in late-onset growth restriction fetuses at the moment of diagnosis. However, its prediction capacity as a standalone parameter is limited. In that context, integrated models of biometric and hemodynamic ultrasound parameters including uterine Doppler have been proposed as an effective approach to stratify the risk and improve perinatal outcomes. Moreover, an association of abnormal uterine artery Doppler and histological findings of placental underperfusion due to vascular obstruction has been described. Finally, it has also been suggested that the evaluation of uterine artery Doppler at third trimester in appropriate-for-gestational-age fetuses could identify cases of subclinical placental insufficiency, but further evidence is needed to define such predictive strategies.

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来源期刊
Minerva obstetrics and gynecology
Minerva obstetrics and gynecology OBSTETRICS & GYNECOLOGY-
CiteScore
2.90
自引率
11.10%
发文量
191
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