Batur Caglayan Hale Z, Nazliel Bijen, Cinar Mehmet, Ataoglu Esra, Moraloglu Ozlem, Irkec Ceyla
a Department of Neurology , Gazi University Faculty of Medicine , Ankara , Turkey.
b Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey.
J Matern Fetal Neonatal Med. 2019 Feb;32(4):584-589. doi: 10.1080/14767058.2017.1387529. Epub 2017 Oct 16.
This prospective observational study aimed to identify the effects of labor on cerebral hemodynamics by measuring the middle cerebral artery (MCA) blood flow velocity by transcranial Doppler ultrasound (TCD), and the related factors just before delivery and within the 24 h after delivery.
The study included 35 healthy pregnant women with a gestational age of >37 weeks who were in labor and a control group including healthy, age-matched, nonpregnant women (n = 24). Demographic characteristics and significant clinical information of pregnant women were recorded. The MCA blood flow velocity was assessed by TCD just before and within 24 h after delivery. The parameters assessed by TCD were mean cerebral blood flow velocity (MCBFV), peak systolic velocity (PSV), pulsatility index (PI), resistance index (RI), and systolic/diastolic ratio.
There was no significant difference between the pregnant and nonpregnant women regarding age (27 ± 5 years versus 28 ± 7 years; p = .751). The MCBFV, PSV, PI, and RI showed a significant increase within the 24 h after delivery as compared with those before delivery. Comparison of the pregnant women with the control group in terms of the values of all parameters related to the MCA blood flow velocity revealed that the values that were significantly low before delivery reached to the level of the control group after delivery Conclusion: The findings of this study demonstrated that the blood flow velocity of the MCA decreased during the late pregnancy period and increased in the early postpartum period to the level similar to that of the nonpregnant group.
这项前瞻性观察性研究旨在通过经颅多普勒超声（TCD）测量大脑中动脉（MCA）血流速度，确定分娩对脑血流动力学的影响，以及分娩前和分娩后24小时内的相关因素。
该研究纳入了35名孕周>37周且正在分娩的健康孕妇，以及一个由年龄匹配的健康非孕妇组成的对照组（n = 24）。记录孕妇的人口统计学特征和重要临床信息。在分娩前和分娩后24小时内通过TCD评估MCA血流速度。通过TCD评估的参数包括平均脑血流速度（MCBFV）、收缩期峰值速度（PSV）、搏动指数（PI）、阻力指数（RI）和收缩/舒张比。
孕妇和非孕妇在年龄方面无显著差异（27±5岁对28±7岁；p = 0.751）。与分娩前相比，MCBFV、PSV、PI和RI在分娩后24小时内显著增加。将孕妇与对照组在所有与MCA血流速度相关的参数值方面进行比较，发现分娩前显著较低的值在分娩后达到了对照组的水平。结论：本研究结果表明，MCA血流速度在妊娠晚期降低，在产后早期增加至与非妊娠组相似的水平。
