Morales Roselló José, Hervás Marín David, Perales Marín Alfredo, López Fraile Sara
Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
J Clin Ultrasound. 2013 May;41(4):224-9. doi: 10.1002/jcu.22025. Epub 2012 Dec 27.
To compare the brain sparing mechanism of the fetal vertebral artery (VA), with the one of the middle cerebral artery (MCA) in fetuses with increased umbilical artery (UA) Doppler impedance.
We retrospectively studied 1084 Doppler examinations of the VA, MCA and UA performed in 1084 fetuses between 19 and 41 week of gestation. These were divided into 3 groups according to the UA resistance index (UA RI): group 1: UA RI < 95(th) percentile (N = 965), group 2: UA RI > 95(th) percentile (N = 111) and group 3: absent UA diastolic flow (N = 8). Afterwards, values were converted into multiples of the median (MoM), and means and standard deviations were calculated. Finally, Kruskal-Wallis tests and box and whiskers charts were applied to evaluate differences.
For both, the VA RI and MCA RI, no differences were seen among the groups of fetuses who maintained diastolic flow in the UA. However, the VA RI and MCA RI were lower when the UA diastolic flow was absent.
The VA and MCA work in unison, decreasing impedances only when UA flow is severely affected.
比较脐动脉（UA）多普勒阻抗增加的胎儿中，胎儿椎动脉（VA）与大脑中动脉（MCA）的脑保护机制。
我们回顾性研究了1084例妊娠19至41周胎儿的VA、MCA和UA的多普勒检查。根据UA阻力指数（UA RI）将这些胎儿分为3组：第1组：UA RI<第95百分位数（N = 965），第2组：UA RI>第95百分位数（N = 111），第3组：UA舒张期血流消失（N = 8）。之后，将数值转换为中位数倍数（MoM），并计算均值和标准差。最后，应用Kruskal-Wallis检验和箱线图来评估差异。
对于VA RI和MCA RI，在UA中维持舒张期血流的胎儿组之间未观察到差异。然而，当UA舒张期血流消失时，VA RI和MCA RI较低。
VA和MCA协同工作，仅在UA血流严重受影响时降低阻抗。
