Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, Bornova, Turkey.
Acta Obstet Gynecol Scand. 2013 Jun;92(6):656-61. doi: 10.1111/aogs.12070. Epub 2013 Feb 15.
To identify the role of longitudinal measurements of fetal aortic isthmus blood flow using Doppler ultrasonography in the prediction of perinatal morbidity and mortality.
Obstetrics department of a university hospital. POPULATION AND DESIGN: This prospective study includes women with fetal growth restriction and abnormal umbilical artery Doppler results, seen between November 2009 and January 2011.
31 women were divided into two groups according to the aortic isthmus blood flow pattern just before birth: anterograde (n = 12) or retrograde (n = 19).
Longitudinal measurements of fetal aortic isthmus in relation to perinatal outcome.
Total morbidity and mortality rates were significantly higher in the retrograde flow group. There was no statistically significant difference for respiratory distress syndrome, intraventricular hemorrhage, bronchopulmonary dysplasia or necrotizing enterocolitis, but the neonatal sepsis rate was significantly higher in the retrograde flow group. An abnormal aortic isthmus flow pattern was detected approximately 15-20 days after umbilical artery and middle cerebral artery Doppler flow abnormalities and 3-7 days before deterioration in ductus venosus blood flow.
We suggest that aortic isthmus Doppler measurements are useful for identifying fetal growth restriction before deterioration in ductus venosus blood flow and fetal acidosis.
利用多普勒超声技术检测胎儿主动脉峡部血流的纵向变化，预测围产儿发病率和死亡率。
某大学医院妇产科。
本前瞻性研究纳入了 2009 年 11 月至 2011 年 1 月期间就诊的胎儿生长受限且脐动脉多普勒结果异常的孕妇。
根据分娩前胎儿主动脉峡部血流模式将 31 名孕妇分为两组：正向组（n=12）或反向组（n=19）。
胎儿主动脉峡部的纵向测量与围产儿结局的关系。
反向血流组的总发病率和死亡率明显更高。两组间呼吸窘迫综合征、脑室内出血、支气管肺发育不良或坏死性小肠结肠炎的发生率无统计学差异，但反向血流组的新生儿败血症发生率明显更高。脐动脉和大脑中动脉多普勒血流异常后约 15-20 天、脐静脉血流恶化前 3-7 天即可检测到异常的主动脉峡部血流模式。
我们建议，主动脉峡部多普勒测量对于在脐静脉血流恶化和胎儿酸中毒之前识别胎儿生长受限具有重要意义。
