Drack G, Kirkinen P, Baumann H, Müller R, Huch R
Perinatalphysiologisches Labor, Universitätsspital Zürich.
Z Geburtshilfe Perinatol. 1988 Jul-Aug;192(4):173-7.
Ten gravidae with normal course of pregnancy in the third trimester underwent a bicycle stress test (semi-supine, 75 W, 3 min). By means of pulsed Doppler sonography, a lowering of the resistance index (RI) in the maternal femoral artery from 93% to 69% was ascertained, though also a rise in maximum systolic velocity (VMAX (syst)) from 73 cm/sec to 194 cm/sec, in maximum diastolic velocity (VMAX diast)) from 5 cm/sec to 61 cm/sec, and in the time-averaged maximum velocity (TAVMAX) from 20 cm/sec to 101 cm/sec. These changes are statistically significant. In the maternal common carotid artery these parameters remained stable or changed little, for example VMAX (diast), which dropped from 24 cm/sec before to 19 cm/sec after exercise, and the RI, which rose from 77% to 84%. Neither in the uteroplacental vessels nor in the umbilical artery were any changes in the RI found (40% to 42% and 58% to 57%, respectively). The fetal cardiotachograms were normal in all cases, while not all cases manifested a rise in fetal heart rate following maternal stress. These results indicate that uteroplacental perfusion and the umbilical circulation remain constant. Doppler sonography thus demonstrates directly and noninvasively that provided placental function is normal the uteroplacental and fetoplacental circulation are not influenced by moderate physical exertion.
十名妊娠晚期妊娠过程正常的孕妇进行了自行车应激试验(半仰卧位,75瓦,3分钟)。通过脉冲多普勒超声检查发现,孕妇股动脉阻力指数(RI)从93%降至69%,同时最大收缩期速度(VMAX(syst))从73厘米/秒升至194厘米/秒,最大舒张期速度(VMAX diast)从5厘米/秒升至61厘米/秒,时间平均最大速度(TAVMAX)从20厘米/秒升至101厘米/秒。这些变化具有统计学意义。在孕妇颈总动脉中,这些参数保持稳定或变化不大,例如VMAX(diast),运动前为24厘米/秒,运动后降至19厘米/秒,RI从77%升至84%。在子宫胎盘血管和脐动脉中均未发现RI有任何变化(分别为40%至42%和58%至57%)。所有病例的胎儿心动图均正常,但并非所有病例在孕妇应激后都出现胎儿心率升高。这些结果表明子宫胎盘灌注和脐循环保持恒定。多普勒超声检查因此直接且无创地证明,在胎盘功能正常的情况下,子宫胎盘和胎儿胎盘循环不受适度体力活动的影响。