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Purpose of monitoring pregnant in late pregnant women radial pulse wave hemodynamic parameters: mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), total peripheral resistance (TPR), the waveform coefficient (K), blood viscosity ( V), and the mean residence time (Tm), and depicts the pulse waveform chart, observation of hypertensive disorders in pregnancy (Hypertension disorder complicating pregnancy, HDCP) and normal pregnant women hemodynamic changes of, and to explore the hemodynamic changes predictive value (referred to as pulse wave) the HDCP and perinatal child outcome, the occurrence of clinical prediction HDCP and predict perinatal child outcome provides a simple, effective, non-invasive detection methods. Methods January 2007 to July 2008 in Tangshan City, MCH obstetric clinic routine prenatal pregnant women to register their General Information, and pregnant women met the inclusion and exclusion criteria for prospective case-control study . Inclusion criteria: ① primipara; ② Age ≥ 21 years of age and lt; 35 years old; ③ intrauterine pregnancy 20-24 weeks; ④ systolic and diastolic blood pressure the lt; 140/90mmHg by. Exclusion criteria were: ① two consecutive unusual the day sitting systolic blood pressure and (or) diastolic blood pressure ≥ 140/90mmHg; (2) previously diagnosed with high blood pressure disease; ③ serious valvular heart disease, cardiomyopathy, heart failure, diabetes and serious the kidney and liver dysfunction; ④ smoking, alcoholism, drug abuse or a history of mental disease; ⑤ twins or multiple pregnancies; ⑥ associated with other pregnancy complications. Record the general condition of the pregnant women (including age, gravidity, parity, last menstrual collection meets the above criteria pregnant women in the second trimester (20 weeks to 24 weeks) and third trimester (30 weeks to 34 weeks), the expected date of birth, gestational age , height, weight, blood pressure, etc.) and pulse wave detected (detection radial artery blood flow velocity indicators, including mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), total peripheral resistance (TPR) , the waveform coefficients (K), blood viscosity (V) and the average residence time (Tm), and depict the pulse waveform charts). Pulse wave method for the study group, mean arterial pressure method and body mass index method for the control group, respectively, predict pregnant women HDCP and perinatal child outcome. Strict tracking selected cases to pregnancy outcomes, including blood pressure before the recording of maternal childbirth, birth gestational age, birth weight, and 1, 5, 10 minutes after birth, Apgar's score. Discharge diagnosis, the patients were divided into normal group, gestational hypertension, mild preeclampsia and severe preeclampsia group, comparing the second trimester, third trimester of normal and hypertensive disorders in pregnancy groups hemodynamic parameters of test results, hemodynamic changes observed in normal pregnant women and pregnant women HDCP, evaluation of pulse wave method to predict the feasibility of hypertensive disorders in pregnancy, and compare the pulse wave method of mean arterial blood pressure, body mass index predict pregnancy blood pressure effect of the disease, compare three methods to predict the negative forecast positive neonatal Apgar's score and neonatal weight, the application of pulse wave method, the method of mean arterial blood pressure, body mass index method to predict the outcome of perinatal children, to evaluate the predictive value. The results of this study, a total of 702 cases of pregnant women enrolled, lost eight cases, a total of 694 cases of all test items and give birth in Tangshan City, MCH, data integrity. The results of 595 cases of pregnant women did not suffer HDCP, 99 cases of pregnant women for HDCP, 19 cases of gestational hypertension, 27 patients with mild preeclampsia, 53 cases of severe preeclampsia. Abnormal perinatal children include: children of premature birth, small for gestational age children (SGA), stillbirths, fetal growth restriction (FGR), fetal distress. 694 cases of pregnant women fetal outcome in line with the inclusion criteria of the study and the data is complete for the full-term newborns, a total of 644 cases, abnormal perinatal children in a total of 50 cases, including 32 cases of premature children, SGA 8 cases, 6 cases of stillbirths , FGR 3 cases of fetal distress cases. Normal group of pregnant women, the third trimester and second trimester blood flow parameters of test results, CI, TPR pregnancy compared statistically significant (P lt; 0.05), third trimester CI value than the second trimester increased compared to the second trimester, third trimester TPR decreases, other indicators during pregnancy compared with no statistical significance (P gt; 0.05); the second trimester and third trimester of gestational hypertension indicators of maternal blood flow parameters showed no statistical significance (P gt; 0.05 ); compared with mild preeclampsia pregnant women during pregnancy blood flow parameters, the indicators were not statistically significant (P gt; 0.05); severe preeclampsia third trimester MAP value than the second trimester increase was statistically significant ( P lt; 0.001), severe preeclampsia the third trimester TPR value than the second trimester increases were statistically significant (P lt; 0.05), there was no statistical significance (P gt other indicators during pregnancy compared; 0.05) . Second trimester (20 weeks to 24 weeks) normal group and the HDCP test results of blood flow parameters between the groups compared, showing that gestational hypertension group compared with the normal group, in addition to the CI, K between the two groups was statistically significant the rest of the indicators were not statistically significant (P gt; 0.05); mild preeclampsia group compared with the normal group in addition to HR between the two groups had no statistical significance (P gt; 0.05), the rest of the two groups between were statistically significant (P lt; 0.001); severe preeclampsia group and normal group compared to HR between the two groups was not statistically significant (P gt; 0.05), the rest of the indicators between the two groups had statistical significance (P lt; 0.001). In addition, the gestational hypertension group compared with mild preeclampsia, except HR, CI, K statistical significance (P gt; 0.05), the rest of the indicators between the two groups were statistically significant (P lt; 0.05 ); gestational hypertension group with severe preeclampsia group compared between the two groups in addition to HR, CI had no statistical significance (P gt; 0.05) outside of each index between the two groups were statistically significant (P lt; 0.05 ); mild preeclampsia and severe preeclampsia group compared between the two groups was statistically significant (P lt; 0.05) only TPR, the remaining between the two groups was not statistically significant (P gt; 0.05). As the disease worsens, blood flow parameters MAP, K, TPR, Tm, V value gradually increase, CI decreases. Test results of blood flow parameters in the normal group of the third trimester of pregnancy (30 weeks to 34 weeks) and HDCP groups compared with visible gestational hypertension group compared with the normal group, the indicators in addition to the HR Tm between the two groups was not statistically significance (P gt; 0.05) were statistically significant (P lt; 0.05);, other test results are the same with the second trimester. The application pulse wave Prediction pulse wave method sensitivity, specificity HDCP second trimester (20 weeks to 24 weeks) were higher, while the mean arterial pressure method and body mass index method, higher sensitivity but lower specificity; addition, the pulse wave The positive coincidence rate is also higher than the other two methods, the ways of the pulse wave method, mean arterial pressure, body mass index method to predict HDCP positive coincidence rate of 40.11%, 21.65%, 18.03%, and mean arterial pressure method and pulse wave Compared statistically significant (P lt; 0.001) compared to body mass index and pulse wave method was statistically significant (P lt; 0.001), mean arterial pressure law BMI method was no statistical significance (P gt; 0.05 ). The pulse wave Predicting HDCP better than of mean arterial pressure and body mass index method. Third trimester (30 weeks to 34 weeks) pulse wave, mean arterial pressure method, BMI Act 3 ways to predict the HDCP positive coincidence rate of 41.29%, 22.27%, 16.23%, respectively, mean arterial pressure method and pulse wave wears statistically significant (P lt; 0.001), body mass index, pulse wave wears a statistically significant (P lt; 0.001) was statistically significant (P lt; 0.05), mean arterial pressure law BMI wears. So the pulse wave forecast HDCP better than of mean arterial pressure and body mass index method, mean arterial pressure method is better than the body mass index. Pulse Wave Prediction HDCP compliance the third trimester and second trimester of no statistical significance (P gt; 0.05), the same mean arterial pressure method predicted The HDCP compliance the third trimester and the second trimester was no statistical significance (P gt; 0.05), weight Index Prediction compared to the third trimester and second trimester of HDCP compliance was not statistically significant (P gt; 0.05). Pregnant women in the normal group of 595 cases, giving birth to full-term newborns of 590 cases, 3 cases of premature children, small for gestational age children two cases of 19 cases; gestational hypertension pregnant women giving birth to full-term newborns of 16 cases two cases of premature children, severe preeclampsia; stillbirths cases of 27 cases of mild preeclampsia pregnant women giving birth to full-term newborns of 23 cases, 3 cases of premature children, one cases of small-for-gestational-age children; a total of 53 cases of pregnant women, childbirth full-term newborns of 15 cases, 24 cases of premature children, five cases of small-for-gestational-age children, stillbirths five cases, fetal growth restriction three cases, fetal distress cases. Rank sum test P lt; 0.001, it is felt that the normal group with hypertensive disorders in pregnancy, perinatal child outcome differences were statistically significant, the normal group perinatal children ending is better, the more severe hypertensive disorders in pregnancy worse perinatal child outcome. The second trimester pulse wave Prediction negative pregnant newborn 1-minute Apgar's score higher than the pulse wave forecast positive pregnant women and newborns 1-minute Apgar's score was statistically significant (P lt; 0.001) between the two pulse wave method predicts negative pregnant women, newborn child weight is greater than the pulse wave forecast positive pregnant women and newborn weight between the two was statistically significant (P lt; 0.001); MAP method to predict negative pregnant women, newborns one minute Apgar's score is higher than the 1-minute Apgar's score predict positive pregnant women and newborns BMI method was statistically significant (P lt; 0.05) MAP method to predict negative pregnant women, newborns weight greater than the MAP method to predict positive pregnant women and newborn weight between both statistically significant (P lt; 0.05); predict negative pregnant women, newborns, 1-minute Apgar's score, birth weight and BMI method to predict the 1-minute Apgar's score positive pregnant women and newborns, birth weight between the two was not statistically significant (P gt; 0.05); seen that the second trimester of pulse wave Law, MAP of the neonatal one minute Apgar's score, and birth weight predict BMI of the neonatal one minute Apgar's score, the predictive value of neonatal weight needs further study. After statistical analysis, the third trimester of the pulse wave Law, MAP of the neonatal one minute Apgar's score, birth weight predict BMI of the neonatal one minute Apgar's score, the predictive value of neonatal weight needs further study. Second trimester (20 weeks to 24 weeks) of pulse wave Law prediction of perinatal child outcomes, sensitivity and specificity were higher, respectively, 88.00%, 75.16%, and the pulse wave predict positive outcomes of perinatal children conform higher than MAP BMI perinatal child outcomes predicted positive coincidence rate (P lt; 0.001), better prediction of the the second trimester the pulse wave Law of perinatal child outcome. Similarly, the third trimester (30 weeks to 34 weeks) pulse wave method is in line with the predicted positive child outcomes perinatal rate in MAP method, BMI perinatal child outcomes predicted positive coincidence rate (P lt; 0.05, P lt; 0.001), pulse wave better predict the outcome of perinatal children. Pulse wave method in line with expectations for the outcome of perinatal children between the situation the second trimester and third trimester of pregnancy had no statistical significance (P gt; 0.05); same MAP law, the BMI method outcome prediction of perinatal child meets the second trimester third trimester of pregnancy between statistical significance (P gt; 0.05). Conclusion 1. Pulse wave as predicted hypertensive disorders in pregnancy an accurate, reliable, non-invasive detection methods, its predictive value in \. 2 pulse wave method predicted hypertensive disorders in pregnancy in the second trimester and third trimester of pregnancy has the same predictive value. 3. Pulse wave method for predicting the perinatal child outcome has a certain value.
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