Tadmor O, Bocker Y, Rabinowitz R, Aboulafia Y, Yagel S, Stark M, Diamant Y Z, Nitzan M
Department of Obstetrics and Gynecology, Misgav Ladach Hospital, Jerusalem.
Fetal Diagn Ther. 1999 Jan-Feb;14(1):2-10. doi: 10.1159/000020878.
Umbilical artery velocity waves were obtained by Doppler ultrasonography before, during, and after 20 episodes of fetal heart rate (FHR) variable decelerations (VD) during the active stage of labor in 8 women. During 50% of the VD periods, the umbilical artery resistance flow parameters increased significantly (p < 0.01). The increase in resistance preceded the decrease in FHR in six episodes (30%) of VD (AR-VD group; arterial resistance VD) and did not precede the change in FHR in another ten episodes (50%) of VD (VR-VD group; venous resistance VD). In the AR-VD group the FHR accelerations occurred before the decelerations in only 1 case (17%), while in the VR-VD group FHR accelerations preceded the decelerations in 8 out of the 10 episodes (80%). Using these Doppler studies, it may be possible to differentiate between two groups of VD: AR-VD - which are caused by umbilical artery occlusion and thus preceded by a measurable increase in umbilical artery resistance - and VR-VD - which are not preceded by a measurable increase in umbilical artery resistance and may be caused by fetal hypoxia.
对8名产妇在分娩活跃期出现的20次胎儿心率（FHR）变异减速（VD）期间及前后，通过多普勒超声检查获取脐动脉速度波。在50%的VD期间，脐动脉阻力血流参数显著增加（p<0.01）。在6次（30%）VD发作（AR-VD组；动脉阻力VD）中，阻力增加先于FHR下降，而在另外10次（50%）VD发作（VR-VD组；静脉阻力VD）中，阻力增加并不先于FHR变化。在AR-VD组中，仅1例（17%）FHR加速发生在减速之前，而在VR-VD组中，10次发作中有8次（80%）FHR加速先于减速。通过这些多普勒研究，有可能区分两组VD：AR-VD，由脐动脉闭塞引起，因此在脐动脉阻力出现可测量增加之前发生；VR-VD，在脐动脉阻力没有可测量增加之前发生，可能由胎儿缺氧引起。
