Sherer D M, Sokolovski M, Dalloul M, Khoury-Collado F, Abulafia O
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York 11203, USA.
Ultrasound Obstet Gynecol. 2005 May;25(5):454-8. doi: 10.1002/uog.1874.
To assess whether fetal cerebral vascular resistance is affected by the presence of nuchal cord(s) in the third trimester.
A set of 115 patients with well-established dates and singleton, appropriate for gestational age (GA), non-anomalous fetuses with nuchal cord(s) diagnosed with prenatal color Doppler imaging, between 28 and 41 weeks and 115 controls matched for GA, were studied. Patients with hypertension, diabetes and autoimmune conditions were excluded. Doppler indices were obtained from the umbilical artery (UA) and the fetal middle cerebral artery (MCA) upon initial diagnosis of the nuchal cord.
Of 115 GA-matched pairs of pregnancies, 103 fetuses had a single nuchal cord and 12 a double nuchal cord. No significant differences were noted in patient age, gravidity, parity, sonographically estimated fetal weight (SEFW), and growth centile at ultrasonographic diagnosis. Mean UA systolic/diastolic ratio (S/D) was 2.28 +/- 0.32 and 2.36 +/- 0.33 (P = 0.03) and UA resistance index (RI) 0.55 +/- 0.06 and 0.57 +/- 0.06 (P = 0.02) among study and controls, respectively. Mean fetal MCA S/D and RI did not differ significantly between the two groups (fetal MCA S/D 5.01 +/- 1.28 and 5.04 +/- 1.71 (P = 0.86), and mean fetal MCA RI 0.78 +/- 0.06 and 0.78 +/- 0.05 (P = 0.88)). No significant differences were noted in GA at delivery, incidence of meconium-stained amniotic fluid, birth weight, mode of delivery, neonatal gender, 1 and 5 minute Apgar scores, or UA pH and base excess, between study and control patients.
Fetal cerebral vascular resistance is not affected by the presence of nuchal cord(s) in the third trimester of pregnancy.
评估孕晚期脐带绕颈是否会影响胎儿脑血管阻力。
研究了115例孕周明确、单胎、孕龄合适（GA）、产前经彩色多普勒成像诊断为脐带绕颈的非畸形胎儿，孕周在28至41周之间，以及115例与之孕周匹配的对照。排除患有高血压、糖尿病和自身免疫性疾病的患者。在初次诊断脐带绕颈时，从脐动脉（UA）和胎儿大脑中动脉（MCA）获取多普勒指数。
在115对孕周匹配的妊娠中，103例胎儿为单脐带绕颈，12例为双脐带绕颈。在患者年龄、妊娠次数、产次、超声估计胎儿体重（SEFW）以及超声诊断时的生长百分位数方面，未观察到显著差异。研究组和对照组的平均脐动脉收缩/舒张比（S/D）分别为2.28±0.32和2.36±0.33（P = 0.03），脐动脉阻力指数（RI）分别为0.55±0.06和0.57±0.06（P = 0.02）。两组间胎儿大脑中动脉的平均S/D和RI无显著差异（胎儿大脑中动脉S/D为5.01±1.28和5.04±1.71（P = 0.86），胎儿大脑中动脉平均RI为0.78±0.06和0.78±0.05（P = 0.88））。研究组和对照组患者在分娩时的孕周、羊水粪染发生率、出生体重、分娩方式、新生儿性别、1分钟和5分钟阿氏评分，或脐动脉pH值和碱剩余方面均未观察到显著差异。
孕晚期脐带绕颈不影响胎儿脑血管阻力。
