Prefumo F, Risso D, Venturini P L, De Biasio P
U. O. di Ostetricia e Ginecologia, Istituto 'G Gaslini', University of Genova, Italy.
Ultrasound Obstet Gynecol. 2002 Jul;20(1):42-6. doi: 10.1046/j.1469-0705.2002.00710.x.
To calculate reference ranges for ductus venosus Doppler measurements obtained transabdominally at 10-14 weeks of gestation.
Two hundred and one normal fetuses with a crown-rump length (CRL) ranging from 38 to 88 mm were examined in a cross-sectional study. The pulsatility index for veins (PIV), peak velocity during ventricular systole (S-wave), lowest forward velocity during atrial contraction (A-wave) and time-averaged maximum velocity (TAMXV) were recorded from the ductus venosus. Flow velocity waveforms were also classified as normal or abnormal according to the presence (normal) or absence or reversal (abnormal) of frequencies during atrial contraction.
Three of 201 fetuses showed an abnormal flow pattern (1.5%; 95% exact confidence interval, 0.3-4.3%). In the 198 fetuses with a normal flow pattern, the mean PIV ranged from 1.07 at a CRL of 38 mm to 1.00 at a CRL of 88 mm (r = -0.093; P = 0.19). A significant increase in mean blood flow velocity with increasing CRL was noted for the S-wave (27.0 cm/s to 33.6 cm/s; r = 0.17; P = 0.02), the A-wave (5.9 cm/s to 7.8 cm/s; r = 0.14; P = 0.04) and the TAMXV (19.4 cm/s to 25.3 cm/s; r = 0.19; P < 0.01). Crown-rump length-specific reference ranges for each parameter were calculated using the method of scaled absolute residuals.
Abnormal ductus venosus flow patterns could be observed in normal fetuses, even if they ocurred with a low prevalence. Reference values for Doppler measurements were established in fetuses with normal patterns of flow.
计算孕10 - 14周经腹获得的静脉导管多普勒测量的参考范围。
在一项横断面研究中，对201例顶臀长（CRL）为38至88毫米的正常胎儿进行了检查。记录静脉搏动指数（PIV）、心室收缩期峰值速度（S波）、心房收缩期最低正向速度（A波）和时间平均最大速度（TAMXV）。根据心房收缩期频率的存在（正常）或缺失或反向（异常），将流速波形也分类为正常或异常。
201例胎儿中有3例显示血流模式异常（1.5%；95%确切置信区间，0.3 - 4.3%）。在198例血流模式正常的胎儿中，平均PIV范围从CRL为38毫米时的1.07到CRL为88毫米时的1.00（r = -0.093；P = 0.19）。随着CRL增加，S波（27.0厘米/秒至33.6厘米/秒；r = 0.17；P = 0.02）、A波（5.9厘米/秒至7.8厘米/秒；r = 0.14；P = 0.04）和TAMXV（19.4厘米/秒至25.3厘米/秒；r = 0.19；P < 0.01）的平均血流速度显著增加。使用标度绝对残差法计算每个参数的顶臀长特异性参考范围。
即使发生率较低，正常胎儿中也可观察到异常的静脉导管血流模式。为血流模式正常的胎儿建立了多普勒测量的参考值。
