Sase Masakatsu, Miwa Ichiro, Sumie Masahiro, Nakata Masahiko, Sugino Norihiro, Okada Kouichi, Osa Atsushi, Miike Hidetoshi, Ross Michael G
Department of Reproductive, Pediatric, and Infection Science, Division of Medicine for Maternal and Child Health, Yamaguchi University School of Medicine, Japan.
Am J Obstet Gynecol. 2005 Sep;193(3 Pt 2):1000-4. doi: 10.1016/j.ajog.2005.05.044.
Fetal swallowing contributes greatly to amniotic fluid homeostasis and fetal somatic development. Despite the absorption and recirculation of significant volumes of amniotic fluid, little is known about the rates of fetal gastric emptying or gastrointestinal absorption. We sought to determine the patterns of human fetal gastric emptying cycles across gestation.
The gastric emptying cycle of 80 normal human fetuses at 12 to 39 weeks of gestation was studied. Real-time ultrasound examination of the fetal stomach (defined as the largest gastric area inclusive of the pylorus) was recorded continuously for a minimum of 1 hour (60-112 minutes). Images were replayed with measurements of gastric size every minute. The gastric area ratio was defined as the ratio of the fetal gastric area divided by the area of the fetal abdominal transverse section. The changes in gastric area ratio of all subjects were analyzed with the discrete Fourier transform method. The calculable maximum cycle was 60 or 112 minutes, and the minimum cycle was 2 minutes. The highest and second highest peaks of all power spectrum were recorded, and each cycle was converted from frequency of each peak.
The gastric emptying cycles of the highest peak before 24 weeks of gestation were scattered between 30 and 100 minutes with low power. At 32 to 35 weeks of gestation, cycles were focused at approximately 40 minutes with increased power. At term, the cycles increased to >80 minutes. The gastric emptying cycles of the second highest peak were constant at 20 minutes, with stronger power after 24 weeks of gestation.
Fetal gastric emptying cycles normalize during the early third trimester. The near-term evidence of delayed emptying may contribute to newborn infant feeding satiation.
胎儿吞咽对羊水稳态和胎儿躯体发育有很大贡献。尽管大量羊水被吸收和再循环，但关于胎儿胃排空率或胃肠道吸收率却知之甚少。我们试图确定整个孕期人类胎儿胃排空周期的模式。
对80例孕12至39周的正常人类胎儿的胃排空周期进行了研究。对胎儿胃（定义为包括幽门在内的最大胃面积）进行实时超声检查，连续记录至少1小时（60 - 112分钟）。图像每分钟回放一次并测量胃大小。胃面积比定义为胎儿胃面积除以胎儿腹部横截面积。所有受试者胃面积比的变化采用离散傅里叶变换方法进行分析。可计算的最大周期为60或112分钟，最小周期为2分钟。记录所有功率谱的最高和第二高峰值，并将每个周期从每个峰值的频率转换而来。
妊娠24周前最高峰值的胃排空周期分散在30至100分钟之间，功率较低。在妊娠32至35周时，周期集中在约40分钟，功率增加。足月时，周期增加到>80分钟。第二高峰值的胃排空周期在20分钟时恒定，妊娠24周后功率更强。
胎儿胃排空周期在妊娠晚期早期趋于正常。近期胃排空延迟的证据可能有助于新生儿喂养饱腹感。
