Konje J C, Kaufmann P, Bell S C, Taylor D J
Fetal Growth and Development Research Group, Department of Obstetrics & Gynaecology, University of Leicester, England.
Am J Obstet Gynecol. 2001 Sep;185(3):608-13. doi: 10.1067/mob.2001.117187.
The purpose of this study was to examine longitudinally changes in quantified blood volume flow in the uterine arteries during pregnancy with the use of color power angiography.
Color power angiography was used to quantify volume flow in the uterine arteries of 57 women with singleton uncomplicated pregnancies between 20 and 38 weeks' gestation. Comparisons were made between blood flow in the 2 arteries in relation to the location of the placenta. Linear regression models were used to estimate gestational age derived volumetric changes in these vessels.
The diameter of the uterine arteries increased from 2.6 mm (SD, 0.2 mm) at 20 weeks to 4.8 mm (SD, 0.7 mm) at 38 weeks of gestation. The total uterine artery blood volume flow increased from 513 mL/min (SD, 127 mL/min) at 20 weeks to 970 mL/min (SD, 193 mL/min) at 38 weeks. The rate of increase was maximum between 20 and 24 weeks (39 mL/min per week). The laterality of the placenta significantly affected the diameter and blood volume flow in each uterine artery. The diameters on the ipsilateral side were significantly greater (by 10.8% +/- 2.4%) than the diameters on the contralateral side at all gestations (P < .05). Similarly, blood volume flow was significantly greater (by 17.8% +/- 2.2%) on the ipsilateral side at all gestations (P < .05). There were, however, no statistically significant differences between the vessel diameters and blood volume flow in those cases in which the placenta was central. Total uterine artery volume flow per kilogram of estimated fetal weight decreased from 1544 mL/kg per minute at 20 weeks to 296 mL/kg per minute at 38 weeks of gestation.
Total quantified uterine artery blood volume flow increases while blood flow per kilogram of fetal weight decreases with gestation. Blood volume flow in the ipsilateral artery to the placenta was significantly higher than that in the contralateral artery. Calculating total uterine artery volume flow by doubling the blood flow from 1 artery (as was previously done) may therefore either result in an over or underestimation, depending on the relationship between the vessel and the laterality of the placenta. Color power angiography is a simple noninvasive tool for determining uterine artery blood volume flow.
本研究的目的是利用彩色能量血管造影术纵向观察孕期子宫动脉血流量的变化。
采用彩色能量血管造影术对57例孕20至38周单胎妊娠且无并发症的孕妇子宫动脉的血流量进行量化。比较了两条动脉的血流与胎盘位置的关系。使用线性回归模型估计这些血管中孕周相关的容积变化。
子宫动脉直径从孕20周时的2.6毫米（标准差0.2毫米）增加到孕38周时的4.8毫米（标准差0.7毫米）。子宫动脉总血流量从孕20周时的513毫升/分钟（标准差127毫升/分钟）增加到孕38周时的970毫升/分钟（标准差193毫升/分钟）。增加速率在20至24周时最大（每周39毫升/分钟）。胎盘的位置显著影响每条子宫动脉的直径和血流量。在所有孕周，同侧的直径均显著大于对侧（大10.8%±2.4%）（P<0.05）。同样，在所有孕周，同侧的血流量也显著大于对侧（大17.8%±2.2%）（P<0.05）。然而，在胎盘位于中央的情况下，血管直径和血流量之间没有统计学上的显著差异。每千克估计胎儿体重的子宫动脉总容积流量从孕20周时的1544毫升/千克每分钟降至孕38周时的296毫升/千克每分钟。
随着孕周增加，子宫动脉总血流量增加，而每千克胎儿体重的血流量减少。胎盘同侧动脉的血流量显著高于对侧动脉。因此，像之前那样将一条动脉的血流量加倍来计算子宫动脉总容积流量，可能会导致高估或低估，这取决于血管与胎盘位置的关系。彩色能量血管造影术是一种用于确定子宫动脉血流量的简单无创工具。
