Hemodynamics Changes Of Patients With Pregnancy Failure By Means Of Transvaginal Color Doppler Ultrasonography

Objective: Transvaginal color Doppler ultrasonography measuring uterine artery takes advantage of noninvasive,simple,and easy to be completed in the early pregnancy examination.Previous studies show that reports are different on uterine artery blood flow parameters of the embryo damage.My research intents to increase the samples transvaginal color Doppler ultrasonography measuring uterine artery blood flow parameters' change,including S/D,RI,and PI to locate the uterine artery's blood flow parameters change order of patients with embryo failures and find out correlation of normal early pregnant uterine artery blood flow parameter to study the predictive value of uterine artery blood flow parameters on embryo failures.Methods: Selecting cases of early pregnant women treated in my hospital from Dec.2014 to Dec.2015.with inclusion criteria as follows: 1.Regular menstrual cycle;2.6-12 weeks' menolipsis with positive urine HCG and positive blood HCG;3.a single gestational sac in uterine cavity imaged by UT;4.With or without vaginal bleeding or abdominal pain.And with exclusion criteria as follows: 1.Autoimmune disorders,endocrine abnormalities,uterine malformation,inflammation,tumor,chromosomal abnormalities;2.Disease affecting hemodynamics as thyroid dysfunction,hypertension,diabetes,heart disorders and the like;3.twins and multiple births pregnancy imaged by UT.717 cases of pregnant women were in conformity with the above standards,of which both 41 cases continuing to be examined in my hospital and 63 cases offering to request abortion were loss to follow-up,and of which 27 cases followed up were ended with embryo failure and classified as the embryo-failure transition group(Group C),which including survival period and stopped-growth period,as well as the remaining 482 cases followed up until 12 weeks with no obviously fetal malformations and consistent with the menolipsis gestational age were classified as normal control group(Group A).Refer to the evaluation criteria of embryo failure propose by the American Association of Sonographers and Radiologists as follows with transvaginal ultrasound: 1 embryo length ?5mm,no primitive heart beat,suggested to be reexamined after 7-10 days 2.embryo length > 5mm,no primitive heart beat,3 average internal diameter of gestational sac >20mm,no yolk sac and embryo.4 internal diameter of gestational sac?20mm,no yolk sac and embryo,suggested to reexamined after 1-2 weeks,still no yolk sac and embryo.104 cases diagnosed clearly as embryo failure were included in the embryo stop group(Group B).SPSS19.0 software statistical system are applied to analyzed P < 0.05 is statistically significant in comparison either in each group for the self matched pairs test or between the groups for rank sum tests.Result:1 Ages of pregnant women are no statistically significant.2 Blood flow parameters of left and right uterine arteries in each group are no statistically significant.3 Both uterine artery's blood flow parameter values and S/D?RI?PI values' change scope of normal control group(Group A)in different gestational weeks are obtained and the former are gradually decreased with the development of gestational weeks.4 Both uterine artery's blood flow parameter values and S/D?RI?PI values' change scope of embryo stop group(Group B)in different gestational weeks are obtained and the former are gradually decreased with the development of gestational weeks.5 Compared with normal control group(Group A),both uterine arteries' blood flow parameter value and S/D.RI.PI's value of the embryonic stopped-growth group(Group B)are apparently lower than its,and differences between different blood flow parameter are statistically significant(P<0.01).6 Compared with normal control group(Group A)in the same gestational weeks,uterine arteries' blood flow parameter value of survival period of embryonic stopped-growth transition group(Group C)is apparently higher than its,differences of blood flow parameters between both groups are statistically significant(P<0.05).7 Embryonic stopped-growth transition group(Group C)include survival period and stopped-growth period,compared with stopped growth period,both uterine arteries' blood flow parameter value of survival period is apparently higher than its,differences of blood flow parameters between both groups are statistically significant(P<0.01).Conclusion: By increasing the samples,based on the original diagnosis of embryo failure by means of transvaginal color Doppler,the blood flow's hemodynamics is studied which finds out that in normal pregnancy,with the increase of gestation weeks,uterine artery's blood flow parameters S/D,RI,PI value decreased gradually reflecting uterine placenta's blood supply is gradually increased to meet the needs of embryonic growth and development;uterine artery blood flow parameters of embryonic stopped-growth transition group show gradually transient.increase of S/D,RI,PI's values,which may be related with both uterine embryo's placental blood supply disorder and transient "compensatory" mechanism;embryo stopped-growth group,with the increases of gestation weeks,uterine artery's blood flow parameters are usually reduced to S/D,RI,PI,which may be related with "wilt" embryo stayed in the uterine cavity for a long time.Vasoactive substances produced by inflammatory reaction leads to peripheral vascular dilatation.Therefore,it is very important to monitor the uterine artery in early pregnancy,which can indirectly reflect the blood supply,growth,development status and so on.In early pregnancy,monitoring uterine artery's blood flow parameters is effective index in prediction and diagnosis of embryonic failure which can provide more valuable information for clinicians and favorable bases for the early treatment,and the appropriate measures.