早发型子痫前期患者胎儿脐动脉舒张末期血流缺失或反流的危险 因素及围产儿结局分析.

Objective: To analyze the risk factors and perinatal outcomes of early onset preeclampsia patients with absent or reversed end-diastolic velocity (AREDV) in the umbilical artery. Methods: We retrospectively analyzed the clinical data of 416 pregnant women with early onset preeclampsia admitted from January 2017 to September 2021. These patients were divided into AREDV group (58 cases) and non-AREDV group (358 cases) based on the presence or absence of AREDV before delivery. We compared the clinical data and perinatal outcomes between the two groups. We used binary logistic regression analysis to investigate the risk factors of AREDV in pregnant women with early onset preeclampsia. Results: There were statistically significant differences in gestational age of diagnosis of preeclampsia, hemoglobin levels, alanine aminotransferase and platelet distribution width between the two groups (all P＜0.05). Multivariate logistic regression analysis showed that gestational age of diagnosis of preeclampsia and hemoglobin levels were associated with the occurrence of AREDV in preeclampsia patients. The risk of AREDV in patients whose gestational age ＜28 weeks and between 28 and 29+6 weeks is 8.244 times (95%CI: 2.631- 25.832, P＜0.001) and 6.532 times (95%CI: 2.033-20.985, P=0.002) higher, respectively, compared to those diagnosed at 32 to 33+6 weeks. Early onset preeclampsia patients with hemoglobin ≥135 g/L had a 2.438 times (95%CI: 1.173-5.065, P=0.017) higher risk of developing AREDV compared to those with normal hemoglobin levels. The incidence of intrauterine fetal death and induced abortion in the AREDV group were significantly higher than those in the non-AREDV group. The 1 minute Apgar score、birth weight of newborns and termination of pregnancy weeks in the AREDV group were significantly lower than those in the non-AREDV group (all P＜0.05). Conclusions: For early onset preeclampsia pregnant women with early gestational age of diagnosis of preeclampsia and high hemoglobin levels, it is necessary to strengthen intrauterine monitoring of the fetus and be alert to the occurrence of AREDV. [ABSTRACT FROM AUTHOR]