Tamás Peter, Szilágyi András, Jeges Sára, Vizer Miklós, Csermely Tamás, Ifi Zsolt, Bálint András, Szabó István
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Pécs, Pécs, Hungary.
Acta Obstet Gynecol Scand. 2007;86(6):711-4. doi: 10.1080/00016340701252217.
This study was undertaken to evaluate the effects of maternal central hemodynamics on fetal heart rate patterns near term, with special regard to the maternal body position.
Brief non-stress test and bioimpedance cardiography were carried out in the supine position, then repeated in a full left lateral decubitus position of mothers with singular, 36-39 week-old normal pregnancies in 106 cases. Computer-aided data were processed by SPSS statistic program.
Due to the appearance of inferior vena cava syndrome, examinations had to be interrupted in 6 cases. Analysis of 100 complete registrations revealed a significantly increased number of accelerations, overall and short-term variations, and longer high episodes with lower basal fetal heart rates were found in the lateral decubitus than in the supine maternal position. Turning to the left resulted in a significant increase of the stroke volume; however, due to decreasing pulse rate, the cardiac output remained unchanged. Parameters of non-stress test showed correlations to hemodynamic indices. In the supine position, the short-term variation correlated with cardiac output (r=0.232, p=0.020); in the left lateral position, the number of accelerations correlated with stroke volume (r=0.221, p=0.027) and cardiac output (r=0.220, p=0.028). Changes of stroke volume due to altered body position correlated to similar changes of overall variation (r=0.264, p=0.018), and marginally to those of short-term variation (r=0.221, p=0.051).
Maternal central hemodynamics influences fetal heart rate patterns in connection with different maternal body position.
本研究旨在评估孕晚期母体中心血流动力学对胎儿心率模式的影响，尤其关注母体体位。
对106例妊娠36 - 39周、单胎、正常妊娠的母亲，先在仰卧位进行简短无应激试验和生物阻抗心动图检查，然后在完全左侧卧位重复检查。计算机辅助数据用SPSS统计程序处理。
因出现下腔静脉综合征，6例检查被迫中断。对100份完整记录的分析显示，与仰卧位相比，左侧卧位时加速次数、整体和短期变异性显著增加，且基础胎儿心率较低时的高心率持续时间更长。转向左侧导致每搏输出量显著增加；然而，由于心率下降，心输出量保持不变。无应激试验参数与血流动力学指标相关。在仰卧位时，短期变异性与心输出量相关（r = 0.232，p = 0.020）；在左侧卧位时，加速次数与每搏输出量相关（r = 0.221，p = 0.027）和心输出量相关（r = 0.220，p = 0.028）。体位改变引起的每搏输出量变化与整体变异性的类似变化相关（r = 0.264，p = 0.018），与短期变异性的变化微弱相关（r = 0.221，p = 0.051）。
母体中心血流动力学与不同母体体位相关，影响胎儿心率模式。
