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低リスク集団における妊娠の有害転帰の予測における第2期子宮動脈ドップラー指標の役割
Role of second-trimester uterine artery Doppler indices in the prediction of adverse pregnancy outcomes in a low-risk population.
PMID: 32640073 DOI: 10.1002/ijgo.13302.
抄録
目的:
第2期子宮動脈ドップラー速度計を用いて妊娠の有害な転帰を予測することを評価する。
OBJECTIVE: To evaluate use of second-trimester uterine artery Doppler velocimetry to predict adverse pregnancy outcomes.
方法:
2017年7月～12月の間にナイジェリアのEkiti State University Teaching Hospitalに通院している単胎妊娠の低リスク無月経妊娠女性を対象とした前向き縦断的研究。妊娠22～26週目に子宮動脈ドップラー指標を測定した。抵抗指数（RI）0.58以下、脈動指数（PI）1.6以下を正常とした。ドップラー指標が妊娠の不利な転帰を予測する能力を決定した。
METHODS: A prospective longitudinal study among low-risk nulliparous women with singleton pregnancies attending Ekiti State University Teaching Hospital, Nigeria, between July and December 2017. Uterine artery Doppler indices were measured at 22-26 gestational weeks. Resistance index (RI) of 0.58 or less and pulsatility index (PI) of 1.6 or less were considered normal. The ability of Doppler indices to predict adverse pregnancy outcomes was determined.
結果:
120名の女性のうち、73名（60.8％）の女性がドップラー指標の異常を少なくとも1つ、50名（41.7％）の女性が妊娠に有害な転帰を少なくとも1つ持っていた。子癇前症では、RIの感度と特異度はそれぞれ40.0％と37.3％（曲線下面積[AUC]、0.28）、PIの感度と特異度はそれぞれ20.0％と89.1％（AUC、0.33）であった。子宮内発育制限では、RIの感度は23.1％、特異度は34.6％（AUC、0.22）、PIの感度は0％、特異度は86.95％（AUC、0.48）であった。低出生体重児では，RIの感度は60.0％，特異度は38.9％（AUC，0.54），PIの感度は20.0％，特異度は90.5％（AUC，0.55）であった。
RESULTS: Among 120 women, 73 (60.8%) women had at least one abnormal Doppler index and 50 (41.7%) at least one adverse pregnancy outcome. For pre-eclampsia, sensitivity and specificity of RI were 40.0% and 37.3% (area under curve [AUC], 0.28), and those of PI were 20.0% and 89.1% (AUC, 0.33) respectively. For intrauterine growth restriction, sensitivity and specificity of RI were 23.1% and 34.6% (AUC, 0.22), and those of PI were 0% and 86.95% (AUC, 0.48), respectively. For low birthweight, sensitivity and specificity of RI were 60.0% and 38.9% (AUC, 0.54), and those of PI were 20.0% and 90.5% (AUC, 0.55), respectively.
結論:
第2期後期の子宮動脈ドップラー速度測定は、リスクの低い集団では妊娠の有害な転帰を予測する能力は限られていた。
CONCLUSION: Late second-trimester uterine artery Doppler velocimetry had limited ability to predict adverse pregnancy outcomes in a low-risk population.
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