Hsu T Y, Ou C Y, Chang S Y, Cheng B H, Chen J H, Hsu P H, Tsai W L
Department of Obstetrics & Gynecology, Chang Gung Memorial Hospital, Niaosung, Taiwan, ROC.
Chang Gung Med J. 2001 Nov;24(11):717-23.
We attempted to establish normal Doppler flow velocity waveform patterns in the human fetal ductus venosus (DV), and also to establish a standardized measurement technique.
Ductus venosus blood flow was measured in a prospective study involving 545 fetuses aged between 8 and 38 weeks in utero, the mothers of whom received prenatal care in Kaohsiung Chang Gung Memorial Hospital in a 12-month period in 1998-1999. Several DV hemodynamic parameters were assessed, including peak systolic velocity (DVP), peak systolic/diastolic (S/D) ratio, time-averaged velocity (TAMX), maximum velocity during atrial contraction (DVM), pulsatility index (PI), Pourcelot's resistance index (RI), and fetal heartbeat (FHB).
Technically acceptable ductus venosus blood flow velocity waveform patterns were collected from 490 of 545 pregnant women (89.9%). The mean +/- SD value for the peak systolic DV velocity during the time period of 8 to 38 weeks in utero was 0.33 +/- 0.11 meters/sec (m/s), the TAMX being 0.24 +/- 0.09 m/s. The maximum velocity during atrial contraction was 0.15 +/- 0.09 m/s, and the peak S/D velocity ratio was 2.5 +/- 1.01. The PI, Pourcelot's RI and fetal heart beat were, 0.67(+/- 0.21), 0.64 (+/- 0.11), and 163.3 (+/- 18.82 bpm), respectively. Significant increases in DVP, TAMX, and DVM with advancing gestational age were established, and decreases in PI, RI, S/D, and FHB with advancing gestational age were also observed.
Further investigation of DV hemodynamics throughout pregnancy may enable a greater understanding of normal placental perfusion, the fetal venous return to the heart and associated cardiac function.
我们试图建立人类胎儿静脉导管（DV）的正常多普勒血流速度波形模式，并建立一种标准化的测量技术。
在一项前瞻性研究中，对545例孕龄在8至38周的宫内胎儿进行静脉导管血流测量，这些胎儿的母亲于1998 - 1999年的12个月内在高雄长庚纪念医院接受产前检查。评估了几个静脉导管血流动力学参数，包括收缩期峰值速度（DVP）、收缩期峰值/舒张期（S/D）比值、时间平均速度（TAMX）、心房收缩期最大速度（DVM）、搏动指数（PI）、普氏阻力指数（RI）和胎儿心率（FHB）。
从545名孕妇中的490名（89.9%）收集到技术上可接受的静脉导管血流速度波形模式。宫内8至38周期间收缩期峰值静脉导管速度的平均±标准差为0.33±0.11米/秒（m/s），时间平均速度为0.24±0.09 m/s。心房收缩期最大速度为0.15±0.09 m/s，收缩期峰值S/D速度比值为2.5±1.01。搏动指数、普氏阻力指数和胎儿心率分别为0.67（±0.21）、0.64（±0.11）和163.3（±18.82次/分钟）。随着孕周增加，DVP、TAMX和DVM显著增加，同时也观察到PI、RI、S/D和FHB随着孕周增加而降低。
对整个孕期静脉导管血流动力学的进一步研究可能有助于更深入了解正常胎盘灌注、胎儿静脉血回流至心脏及相关心脏功能。
