Satoh Shoji, Fujita Yasuyuki, Yumoto Yasuo, Kinukawa Naoko, Nakano Hitoo
Maternity and Perinatal Care Center, Oita Prefectural Hospital, Oita, Japan.
Ultrasound Med Biol. 2007 May;33(5):708-13. doi: 10.1016/j.ultrasmedbio.2006.11.020. Epub 2007 Apr 16.
The objective was to investigate the relationship between fetal aortic distension waveforms and fetal hypoxemia and/or acidosis. Aortic distension waveforms were recorded using an echo-tracking system in nine late-gestation catheterized fetal lambs. Under hypoxic conditions induced by inhalation of gas mixture, fetal blood pressure and aortic distension waveforms were recorded. Four parameters, namely peak systolic and end diastolic diameter, amplitude (DeltaD) and ratio of DeltaD to end diastolic diameter (%DeltaD), were obtained, and correlations between these parameters and partial arterial oxygen tension (PaO(2)) and pH of fetal blood gas were analyzed. These four parameters were compared between the control, hypoxemic and asphyxic groups. The DeltaD and %DeltaD were significantly correlated with PaO(2) and pH using linear regression analysis. Both the DeltaD and %DeltaD decreased significantly, in a stepwise fashion, in the hypoxemic and asphyxiated groups compared with controls using repeated measured analysis of variance. It was concluded that fetal aortic distension waveforms proved to be a useful tool to detect the deterioration in the fetal circulation secondary to intrauterine hypoxemia/asphyxia.
目的是研究胎儿主动脉扩张波形与胎儿低氧血症和/或酸中毒之间的关系。使用回声跟踪系统记录了9只妊娠晚期经导管插入的胎儿羔羊的主动脉扩张波形。在吸入混合气体诱导的缺氧条件下,记录胎儿血压和主动脉扩张波形。获得了四个参数,即收缩期峰值和舒张末期直径、幅度(DeltaD)以及DeltaD与舒张末期直径的比值(%DeltaD),并分析了这些参数与胎儿血气的动脉血氧分压(PaO₂)和pH值之间的相关性。比较了对照组、低氧血症组和窒息组的这四个参数。使用线性回归分析,DeltaD和%DeltaD与PaO₂和pH值显著相关。使用重复测量方差分析,与对照组相比,低氧血症组和窒息组的DeltaD和%DeltaD均显著逐步下降。得出的结论是,胎儿主动脉扩张波形被证明是检测宫内低氧血症/窒息继发的胎儿循环恶化的有用工具。