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母体高氧对正常生长胎儿和宫内生长受限胎儿循环系统的影响。我们能从这种影响中学到什么。

The effect of maternal hyperoxygenation on fetal circulatory system in normal growth and IUGR fetuses. What we can learn from this impact.

作者信息

Khatib Nizar, Thaler Israel, Beloosesky Ron, Dabaja Hanin, Ganem Nadir, Abecassis Philippe, Ginsberg Yuval, Weiner Zeev

机构信息

a Rambam Medical Center , Haifa , Israel.

b Rambam Health Care Campus , Haifa , Israel.

出版信息

J Matern Fetal Neonatal Med. 2018 Apr;31(7):914-918. doi: 10.1080/14767058.2017.1301925. Epub 2017 Mar 21.

Abstract

PURPOSE

The objectives of study were to assess and compare the effects of maternal hyperoxygenation on fetal circulation, in fetuses with intrauterine growth retardation and normal fetal growth.

METHODS

Twelve singleton pregnant women with normal fetal growth and 12 singleton pregnant women with intrauterine growth restriction were recruited. Mean gestational age of 35.2 ± 3.5 and 34.7 ± 3.9 weeks, respectively. Doppler blood flow velocity waveforms were obtained from the middle cerebral artery, umbilical, main and proximal right pulmonary arteries. Pulsatility indices were calculated for all the vessels. Peak systolic velocity was determined for the middle cerebral artery. Following baseline measurements; each woman received 70% humidified oxygen for 10 min. Doppler measurements were then repeated.

RESULTS

The pulsatility index in the middle cerebral artery increased significantly from 1.5 ± 0.27 to 1.88 ± 0.48, respectively (p = .006) in the high-risk group. However, it did not change significantly in the low-risk group. Hyperoxygenation caused a significant decrease in pulsatility indices in the pulmonary arteries for both groups.

CONCLUSIONS

Hyperoxygenation interrupts the relative brain-sparing effect in the intrauterine growth retardation group, but it did not significantly change the pulsatility index of the middle cerebral artery in fetuses with adequate weight. The pulsatility index in the pulmonary arteries decreased significantly following hyperoxygenation.

摘要

目的

本研究的目的是评估和比较母体高氧对宫内生长受限胎儿和正常生长胎儿的胎儿循环的影响。

方法

招募了12名单胎妊娠且胎儿生长正常的孕妇和12名单胎妊娠且宫内生长受限的孕妇。平均孕周分别为35.2±3.5周和34.7±3.9周。从大脑中动脉、脐动脉、主肺动脉和右肺近端动脉获取多普勒血流速度波形。计算所有血管的搏动指数。测定大脑中动脉的收缩期峰值速度。在进行基线测量后,每位孕妇接受10分钟的70%湿化氧气。然后重复进行多普勒测量。

结果

高危组大脑中动脉的搏动指数分别从1.5±0.27显著增加至1.88±0.48(p = 0.006)。然而,低危组未发生显著变化。高氧导致两组肺动脉搏动指数显著降低。

结论

高氧中断了宫内生长受限组相对的脑保护效应,但对体重正常胎儿大脑中动脉的搏动指数无显著影响。高氧后肺动脉搏动指数显著降低。

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