Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan.
J Perinat Med. 2019 Jul 26;47(5):558-563. doi: 10.1515/jpm-2018-0344.
Objective To assess fetal behavioral changes in response to vibroacoustic stimulation (VAS) in normal singleton pregnancies using four-dimensional (4D) ultrasound. Methods Ten types of fetal movements and facial expressions in 68 healthy pregnant women between 24 and 40 weeks were studied using 4D ultrasound for 3 min before and after 3-s VAS. The frequencies of mouthing, yawning, tongue expulsion, back arch, jerky arm movement, startle movement, smiling, scowling, hand-to-face movement, and blinking were evaluated. The fetuses were subdivided into four gestational age groups (24-27, 28-31, 32-35, and ≥36 weeks). Comparison of the frequencies of the fetal behaviors before and after the stimulation in each gestational age group was conducted to detect the response to stimulation with advancing gestation. Results There were no significant differences in the frequency of each fetal behavior before and after VAS at 24-27, 28-31, and 32-35 weeks of gestation. However, the frequencies of blinking and startle movements were significantly higher after VAS in the 36-40 gestational age group (P < 0.05). Conclusion The age of 36 weeks of gestation might represent an advanced stage of brain and central nervous system development and maturation as the response to stimuli is prominent at this age compared with earlier gestation.
目的 利用四维(4D)超声评估正常单胎妊娠胎儿对声振刺激(VAS)的行为变化。
方法 对 68 例 24-40 周健康孕妇进行 4D 超声检查,在 3s VAS 前后分别记录 3 分钟胎儿的 10 种运动和面部表情,评估咂嘴、打哈欠、伸舌、弓背、惊跳样手臂运动、惊跳样运动、微笑、皱眉、手摸脸和眨眼的频率。将胎儿分为四个孕龄组(24-27 周、28-31 周、32-35 周和≥36 周)。比较每个孕龄组刺激前后胎儿行为的频率,以检测随妊娠进展对刺激的反应。
结果 24-27 周、28-31 周和 32-35 周妊娠时,VAS 前后胎儿各行为频率无显著差异。然而,36-40 孕周组 VAS 后眨眼和惊跳运动的频率明显升高(P<0.05)。
结论 与妊娠早期相比,36 周妊娠时大脑和中枢神经系统的发育和成熟可能进入一个高级阶段,因为此时对刺激的反应更为明显。