van Eyck J, van der Mooren K, Wladimiroff J W
Department of Obstetrics and Gynecology, Academic Hospital Rotterdam-Dijkzigt, Erasmus University, The Netherlands.
Am J Obstet Gynecol. 1990 Aug;163(2):558-66. doi: 10.1016/0002-9378(90)91197-k.
A test is needed that would accurately predict favorable neonatal lung performance in the presence of prolonged severe oligohydramnios caused by ruptured membranes so that optimal obstetric care can be provided. We propose such a test that is based on the degree of modulation of fetal ductal blood flow velocity by fetal breathing movements after maternal glucose loading. In a prospective cross-sectional study of 49 normal pregnancies (50 fetuses) between 25 and 38 weeks an exponential increase in breathing-related ductal blood flow velocity modulation was observed with advancing gestational age, reflecting the developing pulmonary vascular bed. Fetal ductal flow velocity waveforms were also recorded in 13 cases of prolonged severe oligohydramnios after ruptured membranes before 28 weeks' gestation. Normal ductal blood flow velocity modulation values were associated with normal neonatal lung performance, whereas reduced ductal blood flow velocity modulation values were associated with pulmonary hypoplasia. Fetal breathing-related ductal flow velocity modulation appears to be a promising predictor of neonatal lung performance.
需要一种测试，能够在胎膜破裂导致长期严重羊水过少的情况下准确预测新生儿良好的肺部表现，以便提供最佳的产科护理。我们提出了这样一种测试，它基于母体葡萄糖负荷后胎儿呼吸运动对胎儿动脉导管血流速度的调节程度。在一项对49例25至38周正常妊娠（50例胎儿）的前瞻性横断面研究中，随着孕周增加，观察到与呼吸相关的动脉导管血流速度调节呈指数增加，这反映了肺血管床的发育。在妊娠28周前胎膜破裂后出现长期严重羊水过少的13例病例中，也记录了胎儿动脉导管血流速度波形。正常的动脉导管血流速度调节值与新生儿良好的肺部表现相关，而降低的动脉导管血流速度调节值与肺发育不全相关。胎儿呼吸相关的动脉导管血流速度调节似乎是新生儿肺部表现的一个有前景的预测指标。
