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常规镁补充对胎儿心脏时间间隔的影响:胎儿心磁图研究。

The effect of routine magnesium supplementation on fetal cardiac time intervals: a fetal magnetocardiographic study.

机构信息

Department of Neonatology, University Children's Hospital Tübingen, Germany.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2013 Jun;168(2):151-4. doi: 10.1016/j.ejogrb.2013.01.001. Epub 2013 Jan 30.

Abstract

OBJECTIVES

Magnesium deficiency in pregnancy is frequent, and in consequence magnesium supplementation is widely used. As magnesium crosses the placental barrier and since the fetal kidney does not excrete magnesium as efficiently as the mature kidney, effects on fetal cardiac time intervals are probable, but still unknown.

STUDY DESIGN

Sixty pregnant women were included in an observational study: 31 patients received oral routine magnesium supplementation. In addition to routine fetal echocardiography, fetal magnetocardiography (fMCG) was used to investigate electrophysiological rhythm patterns with high temporal resolution. fMCG tracings were analyzed according to a predefined procedure for fetal cardiac time interval (CTI)-detection. fCTI findings (P-wave, PQ-segment, PR-interval, QRS complex, ST segment, T-wave and QTc interval) were registered.

RESULTS

Significant widening of the QRS-complex (p=0.004) was demonstrated in fetuses whose mothers received magnesium supplementation (240 mg/day) relative to the control group.

CONCLUSION

Magnesium exposed fetuses demonstrated a prolonged ventricular arousal, but healthy neonatal outcome was found in all exposed fetuses. Although fMCG is a preclinical method and limited in its availability, the procedure could help to monitor fetuses.

摘要

目的

妊娠期间镁缺乏较为常见,因此广泛应用镁补充剂。由于镁可穿过胎盘屏障,且胎儿的肾脏不如成熟肾脏那样有效地排泄镁,因此可能会对胎儿的心脏时间间隔产生影响,但目前尚不清楚。

研究设计

60 名孕妇纳入一项观察性研究:31 名患者接受口服常规镁补充剂。除了常规胎儿超声心动图外,还使用胎儿磁心电图(fMCG)以高时间分辨率研究电生理节律模式。根据预定义的胎儿心脏时间间隔(CTI)检测程序分析 fMCG 轨迹。记录 fCTI 结果(P 波、PQ 段、PR 间期、QRS 复合体、ST 段、T 波和 QTc 间期)。

结果

与对照组相比,接受镁补充剂(240mg/天)的母亲的胎儿 QRS 复合体明显增宽(p=0.004)。

结论

暴露于镁的胎儿表现出心室唤醒时间延长,但所有暴露胎儿均有健康的新生儿结局。虽然 fMCG 是一种临床前方法,且可用性有限,但该程序可帮助监测胎儿。

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