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脐动脉血流速度波形与胎盘阻力:脐循环栓塞的影响

Umbilical artery flow velocity waveforms and placental resistance: the effects of embolization of the umbilical circulation.

作者信息

Trudinger B J, Stevens D, Connelly A, Hales J R, Alexander G, Bradley L, Fawcett A, Thompson R S

机构信息

Department of Obstetrics and Gynecology, University of Sydney at Westmead Hospital, New South Wales, Australia.

出版信息

Am J Obstet Gynecol. 1987 Dec;157(6):1443-8. doi: 10.1016/s0002-9378(87)80241-7.

Abstract

Embolization of the umbilical placental circulation in fetal lambs was carried out to occlude the small vessels of the placental vascular bed and to observe the effect on the umbilical artery flow and flow velocity waveforms. Thirteen singleton fetuses were studied from day 120 of pregnancy. Embolization was achieved by injecting approximately 9 X 10(6) microspheres of 15 micron diameter into the fetal placental cotyledons along the umbilical arteries over 9 days. Umbilical and uterine flows were measured by radioactive microsphere counting. The umbilical placental resistance was increased (0.25 to 0.35 mm Hg.ml.min-1) by embolization, and there was an increase in the umbilical artery systolic/diastolic ratio. Embolization produced a significant fall in umbilical flow expressed either as total flow (312 to 237 ml.min-1) or when normalized by reference against splanchnic flow (3.36 to 1.53). We conclude that the umbilical artery flow velocity waveform systolic/diastolic ratio measures the reflection coefficient at the peripheral vascular bed (the "resistance vessels") of the placenta.

摘要

对胎羊的脐胎盘循环进行栓塞,以闭塞胎盘血管床的小血管,并观察其对脐动脉血流及流速波形的影响。从妊娠第120天起对13只单胎胎儿进行研究。通过在9天内沿脐动脉向胎儿胎盘小叶注射约9×10⁶个直径为15微米的微球来实现栓塞。通过放射性微球计数测量脐部和子宫的血流。栓塞使脐胎盘阻力增加(从0.25增至0.35 mmHg·ml·min⁻¹),脐动脉收缩压/舒张压比值升高。栓塞使脐血流显著下降,无论是以总血流量计算(从312降至237 ml·min⁻¹),还是以相对于内脏血流量进行标准化计算时(从3.36降至1.53)。我们得出结论,脐动脉流速波形的收缩压/舒张压比值可测量胎盘外周血管床(“阻力血管”)处的反射系数。

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