Sodowski Krzysztof, Cnota Wojciech, Czuba Bartosz, Borowski Dariusz, Wielgos Miroslaw, Kaminski Pawel, Jaczyńska Renata, Włoch Agata, Kuka Dorota, Zwirska-Korczala Krystyna, Szaflik Krzysztof
Obstetrics and Gynecology Clinic Ruda Slaaka, Silesian Medical Academy Katowice, Poland.
Neuro Endocrinol Lett. 2007 Oct;28(5):713-6.
The ductus venosus is the very important part of fetal venous circulation. It plays a central role in return of venous blood from the placenta. This unique shunt carries well-oxygenated blood from the umbilical vein through the inferior atrial inlet on its way across the foramen ovale. Using Doppler ultrasound, it is possible to assess the blood flow in fetal vessels including ductus venosus. It is observed, in animal and human studies, that the typical waveform for blood flow in ductus venosus in early pregnancy can be different depending on numerous conditions e.g. fetal karyotype. This study is performed to assess the physiologic parameters of blood flow in ductus venosus in uncomplicated early pregnancy.
404 women were examined between 11+0 and 13+6 weeks (+ days) of gestation by ultrasound. Fetal crown-rump length (CRL) was measured to assess the gestational age. The assessment of risk of fetal abnormalities was based on nuchal translucency (NT) measurement. The ductus venosus blood flow with color and spectral Doppler was obtained in all patients. The following features were assessed: pulsatility index (PI), and direction of flow (positive/negative) during atrial contraction (wave A). All cases were followed up to 22 weeks of gestation when the control scan was performed.
30 cases were excluded from the uncomplicated group due to: high risk of fetal abnormalities, fetal loss, confirmed fetal abnormalities and utero-placental pathology. 374 women were considered as uncomplicated pregnancy. In both uncomplicated and complicated groups the mean values for pulsatility index (PI) were established. The mean PI value in uncomplicated pregnancies was: 0.91 (SD +/- 0.32). No significant differences between groups were noticed. In 370 cases of uncomplicated pregnancy the A wave direction was positive but in 1.1% of cases the reverse flow in atrial contraction was observed.
静脉导管是胎儿静脉循环中非常重要的部分。它在胎盘静脉血回流中起核心作用。这种独特的分流将富含氧的血液从脐静脉经下腔静脉入口输送至卵圆孔。利用多普勒超声，可以评估包括静脉导管在内的胎儿血管中的血流情况。在动物和人体研究中观察到，妊娠早期静脉导管内血流的典型波形可能因多种情况而异，例如胎儿核型。本研究旨在评估单纯性早期妊娠中静脉导管内血流的生理参数。
对404名妊娠11 + 0至13 + 6周（+天数）的妇女进行超声检查。测量胎儿头臀长（CRL）以评估孕周。基于颈部透明带（NT）测量评估胎儿异常风险。对所有患者进行彩色和频谱多普勒检测静脉导管血流。评估以下特征：搏动指数（PI）以及心房收缩期（A波）血流方向（正向/反向）。所有病例随访至妊娠22周时进行对照扫描。
30例因以下原因被排除在单纯组之外：胎儿异常风险高、胎儿丢失、确诊胎儿异常以及子宫 - 胎盘病变。374名妇女被视为单纯妊娠。在单纯组和复杂组中均确定了搏动指数（PI）的平均值。单纯妊娠组的平均PI值为：0.91（标准差±0.32）。两组之间未发现显著差异。在370例单纯妊娠病例中，A波方向为正向，但在1.1%的病例中观察到心房收缩期反向血流。
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