Meyers Mariana L, Mirsky David M, Dannull Kimberly A, Tong Suhong, Crombleholme Timothy M
Department of Pediatric Radiology, Children's Hospital Colorado, Aurora, CO, USA.
Fetal Diagn Ther. 2017;42(2):124-129. doi: 10.1159/000450978. Epub 2016 Nov 1.
Fetal MRI is performed without sedation. In cases of maternal claustrophobia or when reduction of fetal motion is critical, benzodiazepines may help. The purpose of this study was to evaluate the effects of low-dose benzodiazepine on fetal motion MRI and its effect on maternal oxygen levels at higher elevation.
A total of 131 fetal MRI scans performed from March 2012 through December 2013 were studied. Nineteen of the cases were performed following Valium administration. Images were graded with a 5-point Likert scale. Using pulse oximetry, maternal oxygen levels were recorded.
Results were analyzed for each category combining 3 readers' interpretations. Using a 2-sample t test model, the average imaging scores were better for the control than the Valium group (p = 0.0139). Maternal oxygen levels at different times and positions were compared using independent 2-sample t test between the Valium and control groups showing no change in O2 saturation, except when controlling for altitude and gestational age (p = 0.0326).
Administration of low-dose Valium did not decrease fetal motion on MRI. Valium did not pose any risk of maternal hypoxemia, except when controlling for altitude and gestational age on supine position. Thus, caution should be exercised to prevent the risk of fetal hypoxemia.
胎儿磁共振成像（MRI）检查无需镇静。对于有母体幽闭恐惧症的情况或当减少胎儿运动至关重要时，苯二氮䓬类药物可能会有所帮助。本研究的目的是评估低剂量苯二氮䓬类药物对胎儿运动MRI的影响及其对高海拔地区母体氧水平的影响。
对2012年3月至2013年12月期间进行的131例胎儿MRI扫描进行研究。其中19例在给予安定后进行。图像采用5分李克特量表进行评分。使用脉搏血氧饱和度测定法记录母体氧水平。
结合3位阅片者的解读对每个类别进行结果分析。使用双样本t检验模型，对照组的平均成像评分优于安定组（p = 0.0139）。在安定组和对照组之间，使用独立双样本t检验比较不同时间和体位的母体氧水平，结果显示除了在控制海拔和孕周时，氧饱和度没有变化（p = 0.0326）。
低剂量安定的使用并未减少MRI上的胎儿运动。除了在仰卧位控制海拔和孕周时，安定不会造成母体低氧血症的任何风险。因此，应谨慎预防胎儿低氧血症的风险。
