Hypertension in pregnancy is a group of diseases that coexist with pregnancy and increased blood pressure, and its harm to pregnant women and fetuses is extremely significant. In the research related to pregnant women with this disease, research on blood circulation has always been the focus. The hemodynamic status is an effective indicator reflecting the blood supply of the body. Its changes in pregnant women and fetuses with hypertensive disorders in pregnancy are hotspots. It is also a significant difference in research results [1-2], and the difference between pregnant women and fetuses The significance of hemodynamics in the severity of disease is relatively lacking. Therefore, this study explores the relationship between the hemodynamic status of pregnant women and fetuses with hypertension in pregnancy and the severity of the disease. The results are now reported as follows.
1 Materials and methods
1.1 General data A retrospective analysis of the clinical data of 90 pregnant women with hypertension in pregnancy and 90 pregnant healthy pregnant women admitted to our hospital from December 2017 to June 2019. The former was set as the observation group and the latter was set as the control group. Inclusion criteria: 20-40 years old; 33-42 weeks gestational age; single birth. Exclusion criteria: those with other pregnancy diseases; those with chronic underlying diseases; those with co-infection; those with mental and cognitive abnormalities; those with congenital diseases in the fetus. The research subjects have informed consent to this study, and the study has been approved by the hospital ethics committee.
1.2 Methods Color Doppler ultrasound was used to examine the two groups of pregnant women, including the hemodynamic indicators (S/D, PI and RI) of the uterine artery, fetal umbilical artery, and middle cerebral artery. The pregnant women were examined in the supine position , The probe frequency is 3.5 MHz.
1.3 Observation indicators Compare the hemodynamic indicators (S/D, PI and RI) of the uterine artery, fetal umbilical artery, and middle cerebral artery between the two groups of pregnant women. At the same time, the observation group is divided into pregnancy-induced hypertension and preeclampsia according to the severity , Eclampsia, and used Spearman rank correlation to analyze the relationship between the above indicators and the severity of the disease.
1.4 Statistical processing Use SPSS 23.0 software to perform statistical analysis on the obtained data. Measurement data is represented by (x±s), comparison is performed by t test, repeated measurement measurement data is analyzed by variance; count data is represented by rate (%), and comparison is used Word 2 test; Spearman rank correlation analysis research index and disease severity. P<0.05 was considered statistically significant. 2 results 2.1 Comparison of general data between the two groups. The control group, aged 21-40 years, average (28.3±3.7) years old, gestational age 33+3-40+3 weeks, average (38.9±2.0) weeks, pregnancy history: 32 cases, none 58 cases. Observation group, age 21 to 39 years old, average (28.5±3.5) years old, gestational age 33+3 to 41 weeks, average (39.0±1.9) weeks, pregnancy history: 33 cases, no 57 cases; hypertension in pregnancy Severity: 35 cases of hypertension during pregnancy, 35 cases of preeclampsia, 20 cases of eclampsia. There was no statistically significant difference between the two groups' age and pregnancy history (P>0.05), and they were comparable.
2.2 Comparison of uterine artery hemodynamic indexes of pregnant women between the two groups. The uterine artery hemodynamic indexes of pregnant women in the observation group were significantly higher than those of the control group, and the differences were statistically significant (P<0.05), see Table 1. Comparison of uterine artery hemodynamic indexes of pregnant women with different severity levels in the observation group showed statistically significant differences (P<0.05), see Table 2. 2.3 Comparison of fetal umbilical artery hemodynamic indexes between the two groups The fetal umbilical artery hemodynamic indexes in the observation group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05), see Table 3. Comparison of umbilical artery hemodynamic indexes of fetuses with different severity in the observation group showed statistically significant differences (P<0.05), see Table 4. 2.4 Comparison of middle cerebral artery hemodynamic indexes of the two groups of fetuses The middle cerebral artery hemodynamic indexes of fetuses in the observation group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05), see Table 5. And the comparison of the middle cerebral artery hemodynamic indexes of the fetuses with different severity in the observation group, the difference was statistically significant (P<0.05), see Table 6. 2.5 Analysis of the relationship between the hemodynamic status of pregnant women and fetuses and the severity of the disease in pregnancy-induced hypertension. Spearman rank correlation coefficient analysis shows that the hemodynamic indicators of the uterine artery and fetal umbilical artery in pregnant women are positively correlated with the severity of the disease. The index of middle artery hemodynamics was negatively correlated with the severity of the disease (P<0.05), see Table 7. 3 Discussion Hypertension during pregnancy has significant harm to pregnant women and fetuses, and is one of the important causes of maternal and infant death. Clinical studies related to hypertension in pregnancy have shown that the systemic arterioles of patients with this disease are in a significantly abnormal state. Therefore, blood circulation is the hottest aspect of this type of pregnant women and fetuses, and the changes in blood flow state Relatively high aspect [3-4]. Many studies believe that, in addition to the changes in the blood flow of pregnant women, there are relatively more studies on the hemodynamic indicators of the umbilical artery and middle cerebral artery related to the fetus [5-6]. While many related studies exist, the differences in research results are extremely significant. Some studies believe that the uterine artery hemodynamic indicators of pregnant women have changed significantly, but the blood flow indicators of the fetal umbilical artery and middle cerebral artery are not prominent. However, some studies also believe that the above blood flow indicators of the fetus are also significantly abnormal [7-8], which seriously affects the blood flow indicators of the umbilical artery and middle cerebral artery of the fetus, which is significantly different from the fetus of healthy pregnant women [9-11]. At the same time, the results of the research on the relationship between the above blood flow indicators and the severity of hypertension in pregnancy are significantly different [12-15]. In view of the existence of the above factors, the hemodynamic status of pregnant women and fetuses with hypertension in pregnancy is related to the severity of the disease. The relationship exploration is even more necessary. The results of this study showed that the hemodynamic indexes of the uterine artery and fetal umbilical artery in pregnant women with hypertension during pregnancy were significantly higher than those of healthy pregnant women and fetuses (P<0.05). At the same time, the hemodynamic indexes of fetal middle cerebral artery They were significantly lower than those of healthy fetuses (P<0.05), and compared with the uterine artery hemodynamic indexes of pregnant women with hypertension in pregnancy with different severity, the differences were statistically significant (P<0.05), analyzed by Spearman rank correlation coefficient It shows that the hemodynamic indexes of the uterine artery and fetal umbilical artery are positively correlated with the severity of the disease, and the hemodynamic indexes of the fetal middle cerebral artery are negatively correlated with the severity of the disease (P<0.05). The detection of hemodynamic indicators of uterine artery, fetal umbilical artery, and middle cerebral artery is of high significance. It not only helps to provide a reference for the diagnosis and treatment of hypertension in pregnancy, but also helps to understand the severity of the disease. Analyzing the reasons, the changes in the circulatory state of pregnant women caused by hypertension in pregnancy caused abnormal uterine arterial blood flow [16-18], which further affected the blood circulation of the fetus, and the more serious the disease state had adverse effects on hemodynamic The larger the value, the more abnormal the expression of related hemodynamic indicators, so the relationship between them is close [19-21]. In view of the existence of the above factors, during the treatment of pregnant women in this category, the changes in the above indicators should be closely monitored, and the treatment measures should be adjusted according to the fluctuations of the changes. According to the patient's condition, drugs that adjust hemodynamics, including alpha receptors or Receptor blockers, by affecting the state of blood vessels to achieve the purpose of affecting the state of blood flow, and then play a positive regulatory and therapeutic role. In summary, the author believes that the hemodynamic status of pregnant women and fetuses with pregnancy-induced hypertension is closely related to the severity of the disease, and attention should be paid to monitoring the hemodynamic status of such pregnant women and fetuses.
