Selam B, Koksal R, Ozcan T
Department of Obstetrics and Gynecology, Dr Z.T.B. Women's Hospital, Ankara, Turkey.
Ultrasound Obstet Gynecol. 2000 May;15(5):403-6. doi: 10.1046/j.1469-0705.2000.00121.x.
The objective of the current study was to evaluate fetal arterial and venous Doppler parameters in postterm pregnancies with oligohydramnios and those with normal amniotic fluid.
A cross-sectional study was performed in 38 pregnancies beyond 41 weeks' gestation. Pulsed Doppler imaging was used to determine the pulsatility index (PI) for the fetal middle cerebral artery (MCA), renal artery, umbilical artery, inferior vena cava (IVC) and ductus venosus. The amniotic fluid index (AFI) was used for semiquantitive assessment of amniotic fluid volume. Oligohydramnios was defined as an AFI < 5 cm.
Oligohydramnios was detected in 10 cases, and a normal AFI was present in 28 cases. In the presence of oligohydramnios the PI of the MCA was decreased, while the renal artery PI and the MCA PI/UA PI ratio were found to be elevated. In cases of oligohydramnios the PI in the IVC was increased but was unchanged in the ductus venosus.
Oligohydramnios in post-term pregnancies is associated with arterial redistribution of fetal blood flow typifying the brain sparing effect and with decreased resistance in the MCA and increased resistance in the fetal IVC.
本研究的目的是评估羊水过少的过期妊娠和羊水正常的过期妊娠中胎儿动脉和静脉多普勒参数。
对38例妊娠超过41周的孕妇进行了一项横断面研究。使用脉冲多普勒成像来确定胎儿大脑中动脉(MCA)、肾动脉、脐动脉、下腔静脉(IVC)和静脉导管的搏动指数(PI)。羊水指数(AFI)用于羊水体积的半定量评估。羊水过少定义为AFI<5 cm。
10例检测到羊水过少,28例羊水指数正常。在羊水过少的情况下,MCA的PI降低,而肾动脉PI和MCA PI/UA PI比值升高。在羊水过少的病例中,IVC的PI增加,但静脉导管的PI没有变化。
过期妊娠中的羊水过少与典型的脑保护效应的胎儿血流动脉再分布有关,与MCA阻力降低和胎儿IVC阻力增加有关。