Department of Ultrasound, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China.
Chin Med J (Engl). 2012 May;125(9):1608-13.
Umbilical cord around neck, a common obstetric complication, affects fetal hemodynamics. Does it influence fetal cardiac functions? The purpose of this study was to investigate the left and right ventricular systolic and diastolic functions of fetuses with umbilical cord around neck in the third trimester by applying velocity vector imaging (VVI).
Thirty-five cases of fetuses with umbilical cord around neck whose gestational ages from 35 to 40 weeks were selected, including 20 cases of umbilical artery ratio of the highest systolic velocity (S) to the lowest diastolic velocity (D) (S/D) < 3.0 and 15 cases of umbilical artery S/D ≥ 3.0, while 20 cases of normal fetuses of 35 - 40 gestational weeks were selected as the control group. The changes in longitudinal velocity, strain, and strain rate of fetal left and right ventricle in systole and diastole in two groups, and the changes in fetal cardiac function under the situation of umbilical cord around neck were analyzed.
Longitudinal strain and strain rate overall of fetal left and right ventricle in systole and diastole were less in fetuses with umbilical artery S/D (3)3.0 and umbilical cord around neck than those in fetuses with umbilical artery S/D < 3.0 and those in control group (P < 0.05); there was no significant difference (P > 0.05) in longitudinal strain and strain rate overall of fetal left and right ventricle in systole and diastole between fetuses with umbilical artery S/D < 3.0 and those in control group.
Left and right ventricular systolic and diastolic dysfunction was detected in fetuses with umbilical cord around neck and umbilical artery S/D (3)3.0. VVI could sensitively respond to cardiac function changes in fetuses with umbilical cord around neck, which provides another valuable method in the evaluation of fetal cardiac function.
脐带绕颈是一种常见的产科并发症，会影响胎儿的血液动力学。它会影响胎儿的心脏功能吗？本研究旨在应用速度向量成像（VVI）技术探讨妊娠晚期脐带绕颈胎儿左、右心室收缩和舒张功能的变化。
选择 35 例孕龄 35-40 周的脐带绕颈胎儿，其中脐动脉最高收缩速度（S）与最低舒张速度（D）比值（S/D）<3.0 者 20 例，S/D≥3.0 者 15 例，同期选择 20 例孕龄 35-40 周的正常胎儿作为对照组。分析两组胎儿左、右心室收缩期和舒张期的纵向速度、应变和应变率的变化，以及脐带绕颈时胎儿心功能的变化。
脐动脉 S/D（3）3.0 组和脐带绕颈组胎儿左、右心室收缩期和舒张期整体纵向应变和应变率均低于脐动脉 S/D<3.0 组和对照组（P<0.05）；脐动脉 S/D<3.0 组与对照组胎儿左、右心室收缩期和舒张期整体纵向应变和应变率比较，差异无统计学意义（P>0.05）。
脐带绕颈和脐动脉 S/D（3）3.0 可导致胎儿左、右心室收缩和舒张功能障碍。VVI 能敏感地反映脐带绕颈胎儿心脏功能的变化，为评价胎儿心脏功能提供了另一种有价值的方法。
