RESUMO
Objective Severe preeclampsia (sPE), which is usually complicated by small-for-gestational-age (SGA) and immature labor , remains a leading cause of maternal and neonatal mortality and morbidity. This study was to investigate the risk factors of SGA in sPE. Methods We retrospectively analyzed 100 cases of sPE, 35 with SGA (the case group) and the other 65 without it ( the control group ) .We conducted single-factor analysis on the general characteristics and potential impact factors of the patients , i-dentified the independent risk factors of SGA using the un-conditional stepwise logistic model , and assessed the value of umbilical arter-y S/D ratio and proteinuria ration in the diagnosis of sPE with SGA with the ROC curve . Results Compared with the control group , the case group had more cases of early-onset sPE ( P =0.010 ), earlier gestational and delivery weeks (P<0.001), lower neonatal weight at birth ( P<0 .001 ) , higher rate of admission to and longer stay in the neonatal ICU (P<0.001), and higher incidence of neo-natal complications (P<0.05).The case group also showed signifi-cant increases in comparison with the control in the umbilical artery S/D ratio (2.95 ±0.75 vs 2.31 ±0.47, P<0.05), frequency of S/D ratio ≥95th percentile (22.86% vs 6.15%, P<0.01), and rate of proteinuria ≥5 g/24 h (42.86% vs 20.00%, P<0.05).The S/D ratio ≥95th percentile (OR=6.02, 95%CI:2.32-16.78) and proteinuria≥5 g/24 h (OR=1.65, 95%CI:1.56-3.01) were found to be the risk factors of sPE with SGA.The area under the curve was 0.852 for the combination of S/D ra-tio and proteinuria ration in the diagnosis of sPE with SGA (P<0.05). Conclusion Umbilical artery S/D ratio≥95th percentile and proteinuria ≥5 g/24 h contribute to the early prediction, prevention, and prognosis of sPE, and is valuable for the diagnosis of sPE with SGA.
RESUMO
Objective To clarify the reliability of three-dimensional power Doppler as a quantitative method in detecting gestational trophoblastic disease (GTD ) and assessing its therapeutic effect. Methods We prospectively collected a database of 52 patients with GTD diagnosed at the First Affiliated Hospital of Xi’an Jiaotong University from December 201 1 to October 2013 and 30 healthy women as controls.Sonography was performed using a Voluson E8. Resistance index (RI ), vascularization index (VI ), flow index (FI ) and vascularization-flow index (VFI)of the region of interest were collected for further analysis.Results Of the 52 GTD datasets,variation from the mean value was RI 0.47±0.1 7;VI (81.46 ±20.54)%;FI 67.28 ±20.21;and VFI 58.12±25.53.Three-dimensional power Doppler examination indicated that there were significant differences in RI,VI,FI and VFI values between healthy individuals and patients in each subgroup (P <0.01).Further,after combining invasive hydatidiform mole and choriocarcinoma groups,it also showed a significant difference between hydatidiform mole group and the combined malignant group (P <0.01).And the abnormal sonographic and power Doppler findings in GTD were resolved when chemotherapy was given successfully.Conclusion RI,VI,FI and VFI values were more related to the information of tumor blood flow,and more intuitive to manifest the status of the disease.They could be new methods in diagnosing and assessing treatment of GTD for their real-time nature.