Department of Maternal-Fetal Medicine, Hospital Clinic-IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases, Barcelona, Spain.
Ultrasound Obstet Gynecol. 2011 Oct;38(4):400-5. doi: 10.1002/uog.8976. Epub 2011 Jul 26.
To evaluate the changes in myocardial performance index (MPI) and aortic isthmus (AoI) and ductus venosus (DV) Doppler in term, small-for-gestational age (SGA) fetuses with normal umbilical artery (UA) Doppler.
MPI, AoI and DV pulsatility indices (PI) were measured within 1 week prior to delivery in a cohort of 178 term singleton consecutive SGA fetuses with normal UA-PI (< 95(th) percentile) and 178 controls matched by gestational age. Cardiovascular parameters were converted into Z-scores and values above the 95(th) centile defined as abnormal.
Median gestational age at inclusion and at delivery was 35.7 and 38.6 weeks, respectively. Compared to controls, SGA fetuses showed significantly higher values in MPI and AoI-PI and similar values in DV-PI. SGA fetuses showed a significantly higher proportion of increased MPI (28.1 vs. 6.7%; P < 0.01) and abnormal AoI-PI (14.6 vs. 5.1%; P < 0.01) than controls. The proportion of cases with abnormal DV-PI was similar between SGA cases and controls. Retrograde net blood flow in the AoI was observed in 7.3% of the SGA cases and in none of the controls.
A proportion of SGA fetuses show cardiovascular Doppler abnormalities. This information might be of clinical relevance in improving the detection and management of late-onset intrauterine growth restriction.
评估具有正常脐动脉（UA）多普勒的足月、小于胎龄儿（SGA）胎儿的心肌性能指数（MPI）和主动脉峡部（AoI）及静脉导管（DV）多普勒的变化。
在 178 例足月、SGA 且具有正常 UA-PI（<95 百分位）的连续单胎胎儿中，于分娩前 1 周内测量 MPI、AoI 和 DV 搏动指数（PI），并与 178 例按胎龄匹配的对照组进行比较。心血管参数转换为 Z 分数，超过 95 百分位的数值定义为异常。
纳入和分娩时的中位孕龄分别为 35.7 周和 38.6 周。与对照组相比，SGA 胎儿的 MPI 和 AoI-PI 值明显更高，而 DV-PI 值相似。SGA 胎儿的 MPI 增加（28.1%比 6.7%；P<0.01）和 AoI-PI 异常（14.6%比 5.1%；P<0.01）的比例明显高于对照组。SGA 病例与对照组的 DV-PI 异常病例比例相似。AoI 中的逆行净血流在 7.3%的 SGA 病例中观察到，而在对照组中未观察到。
一部分 SGA 胎儿存在心血管多普勒异常。这些信息可能对提高晚期宫内生长受限的检测和管理具有临床意义。
