Boito S M E, Struijk P C, Pop G A M, Visser W, Steegers E A P, Wladimiroff J W
Department of Obstetrics and Gynaecology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Ultrasound Obstet Gynecol. 2004 Apr;23(4):327-32. doi: 10.1002/uog.1012.
To establish the effects of plasma volume expansion (PVE) followed by intravenous dihydralazine (DH) administration on maternal whole blood viscosity (WBV) and hematocrit, uteroplacental and fetoplacental downstream impedance and umbilical venous (UV) volume flow in pre-eclampsia.
In 13 pre-eclamptic women maternal and fetal hemodynamics were established by means of combined measurement of maternal arterial blood pressure (BP), WBV, hematocrit and uterine artery (UtA) resistance index (RI) in addition to umbilical artery (UA) pulsatility index (PI) and UV volume flow obtained from UV vessel area and UV time-averaged flow velocity. In each woman all parameters were measured four times at baseline, after PVE, after DH and 24 h after the start of treatment.
Maternal diastolic BP, hematocrit and WBV display a significant reduction after PVE. In the fetus UA PI decreases significantly whereas a significant increase in UV cross-sectional area was detected. After maternal DH administration, arterial systolic and diastolic BP and UA PI show a significant decrease compared with the measurements following PVE. At 24 h, only maternal systolic and diastolic BP display a significant further decrease. No significant changes were established for the UtA RI, UV time-averaged velocity and UV volume flow during the entire study period.
During pre-eclampsia, maternal PVE followed by DH administration results in a significant reduction in maternal diastolic BP, maternal hematocrit and WBV. Maternal PVE is associated with a significant increase in UV cross-sectional area and a non-significant rise of 11% in UV volume flow. Maternal DH administration does not result in any change in UV cross-sectional area. However, UA PI decreases significantly after both PVE and DH treatment.
探讨扩容后静脉注射双肼屈嗪（DH）对先兆子痫患者母体全血粘度（WBV）、血细胞比容、子宫胎盘和胎儿胎盘下游阻抗以及脐静脉（UV）血流量的影响。
对13例先兆子痫患者，通过联合测量母体动脉血压（BP）、WBV、血细胞比容和子宫动脉（UtA）阻力指数（RI），以及脐动脉（UA）搏动指数（PI）和UV血流量（通过UV血管面积和UV时间平均流速获得）来确定母体和胎儿的血流动力学。在每位患者中，所有参数在基线、扩容后、注射DH后以及治疗开始后24小时测量4次。
扩容后母体舒张压、血细胞比容和WBV显著降低。胎儿方面，UA PI显著降低，同时检测到UV横截面积显著增加。母体注射DH后，与扩容后的测量值相比，动脉收缩压和舒张压以及UA PI显著降低。在24小时时，只有母体收缩压和舒张压进一步显著降低。在整个研究期间，UtA RI、UV时间平均流速和UV血流量没有显著变化。
在先兆子痫期间，母体扩容后注射DH可使母体舒张压、母体血细胞比容和WBV显著降低。母体扩容与UV横截面积显著增加以及UV血流量非显著增加11%相关。母体注射DH不会导致UV横截面积发生任何变化。然而，在扩容和DH治疗后，UA PI均显著降低。
