目的:用无创血流动力学监测系统研究双胎妊娠孕妇的血流动力学特点,及其与妊娠并发症的关系。方法:选择双胎妊娠孕妇118例,分为双胎有并发症组(95例)和双胎无并发症组(23例),另选择同期正常单胎妊娠孕妇(90例)为对照(正常单胎妊娠组)。用无创血流动力学监测系统检测并比较3组孕妇的血流动力学参数:心率(HR)、平均动脉压(MAP)、心脏指数(CI)、心输出量(CO)、周围血管阻力指数(SVRI)和周围血管阻力(SVR)。结果:双胎无并发症组与正常单胎妊娠组比较,HR、CI、CO轻度增高,MAP、SVRI、SVR轻度降低,但差异均无统计学意义(P〉0.05)。双胎有并发症组与另两组比较,CI、CO明显降低(P〈0.05),MAP、SVRI、SVR明显升高(P〈0.05)。结论:双胎妊娠孕妇发生妊娠期高血压、子痫前期、胎儿生长受限与孕妇心排出量降低、外周阻力升高有关。
Objective:To research on the maternal hemodynamic characteristic of twin pregnancy and de- tect the relationship between the hemodynamic alterations and pregnancy complications by using noninvasive hemodynamic monitoring system. Methods:118 twin pregnant women were classified into two groups:one with complicated pregnancy ,the other with uncomplicated pregnancy. The control group consisted of 90 nor- mally single pregnant women. Noninvasive hemodynamic monitoring system was employed to detect and compare maternal hemodynamic parameters in three groups, including HR, MAP, CI, CO, SVRI AND SVR. Results :The heart rate (HR) and cardiac output (CI,CO) of uncomplicated twin pregnancies were slightly higher than those of normal single pregnancies,while the maternal mean arterial pressure (MAP) and pe- ripheral resistance(SVRI,SVR) of the former were slightly lower. But there were no significant differences statistically( P 〉 0. 05). Compared with the other two groups, the complicated twin pregnancies had clearly lower cardiac output (CI, CO) (P 〈 0.05) but remarkably higher MAP and peripheral resistance (SVRI, SVR) ( P 〈 0. 05). Conclusions. Twin pregnancy complicated with gestation hypertension, preeclampsia or fetal growth restriction is associated with reduced maternal cardiac output and increased peripheral resist- ance.