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主动脉峡部和生长受限胎儿的心脏监测。

Aortic isthmus and cardiac monitoring of the growth-restricted fetus.

机构信息

Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Sykehusveien 38, N-9038 Tromsø, Norway.

出版信息

Clin Perinatol. 2011 Mar;38(1):113-25, vi-vii. doi: 10.1016/j.clp.2010.12.006.

DOI:10.1016/j.clp.2010.12.006
PMID:21353093
Abstract

Aortic isthmus acts as an arterial watershed between the cerebral and placental circulations, connecting 2 parallel fetal ventricular pumps. It plays a crucial role in the fetal circulatory dynamics. Information about aortic isthmus blood flow may improve the management of sick fetuses. However, perceived technical difficulties limit the clinical use of aortic isthmus Doppler for fetal hemodynamic monitoring. Changes in aortic isthmus blood flow pattern seem to reflect fetal cardiovascular status accurately and predict perinatal and long-term neurodevelopmental outcome in intrauterine growth restriction. This review evaluates the available scientific information and discusses the role of aortic isthmus in fetal circulation.

摘要

主动脉峡部作为大脑和胎盘循环之间的动脉分水岭,连接着 2 个平行的胎儿心室泵。它在胎儿循环动力学中起着至关重要的作用。主动脉峡部血流信息可能有助于改善患病胎儿的管理。然而,技术上的困难限制了主动脉峡部多普勒在胎儿血流动力学监测中的临床应用。主动脉峡部血流模式的变化似乎能够准确反映胎儿心血管状态,并预测宫内生长受限的围产儿和长期神经发育结局。本综述评估了现有的科学信息,并讨论了主动脉峡部在胎儿循环中的作用。

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1
Aortic isthmus and cardiac monitoring of the growth-restricted fetus.主动脉峡部和生长受限胎儿的心脏监测。
Clin Perinatol. 2011 Mar;38(1):113-25, vi-vii. doi: 10.1016/j.clp.2010.12.006.
2
Doppler assessment of the aortic isthmus and perinatal outcome in preterm fetuses with severe intrauterine growth restriction.对严重宫内生长受限的早产胎儿主动脉峡部进行多普勒评估及围产期结局
Ultrasound Obstet Gynecol. 2008 Jan;31(1):41-7. doi: 10.1002/uog.5237.
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Monitoring of fetuses with intrauterine growth restriction: longitudinal changes in ductus venosus and aortic isthmus flow.监测宫内生长受限胎儿:静脉导管和主动脉峡部血流的纵向变化
Ultrasound Obstet Gynecol. 2009 Jan;33(1):39-43. doi: 10.1002/uog.6278.
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Is it time to add aortic isthmus evaluation to the repertoire of Doppler investigations for placental insufficiency?是时候将主动脉峡部评估纳入胎盘功能不全的多普勒检查项目了吗?
Ultrasound Obstet Gynecol. 2008 Jan;31(1):6-9. doi: 10.1002/uog.5239.
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Retrograde net blood flow in the aortic isthmus in relation to human fetal arterial and venous circulations.主动脉峡部逆行净血流与人类胎儿动静脉循环的关系。
Ultrasound Obstet Gynecol. 2002 Feb;19(2):147-52. doi: 10.1046/j.0960-7692.2001.00626.x.
6
Longitudinal study of aortic isthmus Doppler in appropriately grown and small-for-gestational-age fetuses with normal and abnormal umbilical artery Doppler.正常脐动脉多普勒与异常脐动脉多普勒的适当生长和小于胎龄儿主动脉峡部多普勒的纵向研究。
Ultrasound Obstet Gynecol. 2012 Apr;39(4):414-20. doi: 10.1002/uog.9076.
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Retrograde diastolic blood flow in the aortic isthmus is not a simple marker of abnormal fetal outcome in pregnancy complicated by IUGR--a pilot study.主动脉峡部舒张期逆向血流并非妊娠合并胎儿生长受限异常胎儿结局的简单标志物——一项初步研究。
Ginekol Pol. 2014 Jul;85(7):509-15. doi: 10.17772/gp/1762.
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Central arterial hemodynamics in small-for-gestational-age fetuses before and during maternal hyperoxygenation: a Doppler velocimetric study with particular attention to the aortic isthmus.
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Comparison of perinatal outcome in fetuses with reverse or absent enddiastolic flow in the umbilical artery and/or fetal descending aorta.脐动脉和/或胎儿降主动脉舒张末期血流反向或缺失的胎儿围产期结局比较。
J Perinat Med. 2003;31(4):307-12. doi: 10.1515/JPM.2003.043.
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Aortic Isthmus Doppler Velocimetry in Fetuses with Intrauterine Growth Restriction: A Literature Review.胎儿宫内生长受限的主动脉峡部多普勒速度测量:文献综述。
Rev Bras Ginecol Obstet. 2020 May;42(5):289-296. doi: 10.1055/s-0040-1710301. Epub 2020 May 29.

引用本文的文献

1
Hemodynamic changes and perinatal outcome associated with umbilical artery thrombosis: a retrospective study.与脐动脉血栓形成相关的血液动力学变化和围产儿结局:一项回顾性研究。
Orphanet J Rare Dis. 2024 Mar 5;19(1):100. doi: 10.1186/s13023-024-03107-y.
2
Prenatal Identification of Restrictive and Non-restrictive Ventricular Septal Defects Based on End-Systolic Flow Patterns in the Fetal Aortic Isthmus.基于胎儿主动脉峡部收缩末期血流模式的室间隔缺损限制性与非限制性的产前识别
Pediatr Cardiol. 2020 Feb;41(2):309-315. doi: 10.1007/s00246-019-02257-2. Epub 2019 Nov 16.
3
A computational model of the fetal circulation to quantify blood redistribution in intrauterine growth restriction.
胎儿循环的计算模型,定量分析宫内生长受限中的血液再分布。
PLoS Comput Biol. 2014 Jun 12;10(6):e1003667. doi: 10.1371/journal.pcbi.1003667. eCollection 2014 Jun.