Wenstrom K D, Weiner C P, Williamson R A
Department of Obstetrics and Gynecology, University of Iowa College of Medicine, Iowa City.
Obstet Gynecol. 1991 Mar;77(3):374-8.
Twenty-two of approximately 450 high-risk pregnancies referred to a regional center for a level II sonographic examination after 20 weeks' gestation were characterized by absent or reversed diastolic flow in the umbilical artery. Ten fetuses had congenital malformations or were aneuploid. Ten were growth-retarded in association with other problems: maternal hypertension, preeclampsia, cyanotic heart disease, elevated maternal serum alpha-fetoprotein levels, or twin gestation. In two cases, no etiology could be identified. Knowledge of the fetal karyotype, fetal anatomy, gestational age, maternal disease, and fetal status as determined by other tests of fetal well-being was required to optimize outcome in each case. In view of the heterogeneous etiologies of absent or reversed diastolic flow, management of such cases must be individualized.
在大约450例高危妊娠中，有22例在妊娠20周后被转诊至区域中心进行二级超声检查，其特征为脐动脉舒张期血流缺失或反向。10例胎儿有先天性畸形或染色体异常。10例胎儿生长受限并伴有其他问题：母亲高血压、先兆子痫、先天性心脏病、母亲血清甲胎蛋白水平升高或双胎妊娠。在2例中，无法确定病因。为了使每个病例的结局达到最佳，需要了解胎儿核型、胎儿解剖结构、孕周、母亲疾病以及通过其他胎儿健康检查所确定的胎儿状况。鉴于舒张期血流缺失或反向的病因各异，此类病例的处理必须个体化。
