Li Tian-Gang, Nie Fang, Xu Xiao-Yan
Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou 730050, Gansu Province, China.
Department of Ultrasound Diagnosis, Lanzhou University Second Hospital, Lanzhou 733000, Gansu Province, China.
World J Clin Cases. 2020 Dec 6;8(23):5866-5875. doi: 10.12998/wjcc.v8.i23.5866.
Single umbilical artery (SUA) is the most common umbilical cord malformation in prenatal diagnosis. The presence of an SUA can cause blood circulation disorder in the foetus and functional changes of the foetal heart, affecting foetal circulation. The right ventricular diastolic functions in foetuses with isolated SUA and in normal foetuses in the third trimester were evaluated using the spectral Doppler of blood flow in the foetal ductus venosus (DV).
To evaluate the right ventricular diastolic functions in foetuses with isolated SUA and in normal foetuses in the third trimester.
Colour Doppler was used to measure the spectrum of foetal DV and tricuspid orifice in 34 foetuses with isolated SUA aged 28-39 wk and in age-matched healthy controls. The DV flow velocities and velocity ratios were measured. The early passive/late active (E/A) ratio at the tricuspid orifice and tissue Doppler Tei index of the foetal right ventricular in the two groups were also measured.
During the third trimester, the isolated SUA group showed a lower 'a'-wave peak velocity in the DV than the control group ( < 0.05). The correlations between the velocity ratios and E/A ratio at the tricuspid orifice in the two groups were analysed, and the correlation between the ventricular late diastolic velocity/ventricular diastolic peak flow velocity and E/A ratios was the best (R of the isolated SUA group: 0.520; R of the control group: 0.358). The correlations between the velocity ratios and tissue Doppler Tei index of foetal right ventricular in the two groups were analysed, and the correlation between the pulsatility index for veins (PIV) and tissue Doppler Tei index ratios was the best (R of the isolated SUA group: 0.865; R of the control group: 0.627).
In the isolated SUA group, the atrial systolic peak velocity 'a' decreased, and this finding might be related to the changes in foetal cardiac functions. The ratio of ventricular late diastolic velocity to ventricular diastolic peak flow velocity was closely related to the E/A ratio at the tricuspid valve and can be used to identify changes in the right ventricular diastolic functions of isolated SUA and healthy foetuses. PIV was closely related to the tissue Doppler Tei index of the foetal right ventricular and can be used to identify the right ventricular overall functions of isolated SUA and healthy foetuses.
单脐动脉（SUA）是产前诊断中最常见的脐带畸形。SUA的存在可导致胎儿血液循环紊乱及胎儿心脏功能改变，影响胎儿循环。采用胎儿静脉导管（DV）血流频谱多普勒评估孤立性SUA胎儿及孕晚期正常胎儿的右心室舒张功能。
评估孤立性SUA胎儿及孕晚期正常胎儿的右心室舒张功能。
应用彩色多普勒测量34例孕28 - 39周的孤立性SUA胎儿及年龄匹配的健康对照胎儿的DV频谱和三尖瓣口频谱。测量DV血流速度及速度比值。同时测量两组胎儿三尖瓣口的早期被动/晚期主动（E/A）比值及胎儿右心室组织多普勒Tei指数。
孕晚期，孤立性SUA组DV的“a”波峰值速度低于对照组（P<0.05）。分析两组速度比值与三尖瓣口E/A比值之间的相关性，其中心室舒张末期速度/心室舒张期峰值流速与E/A比值的相关性最佳（孤立性SUA组R = 0.520；对照组R = 0.358）。分析两组速度比值与胎儿右心室组织多普勒Tei指数之间的相关性，其中静脉搏动指数（PIV）与组织多普勒Tei指数比值的相关性最佳（孤立性SUA组R = 0.865；对照组R = 0.627）。
在孤立性SUA组中，心房收缩期峰值速度“a”降低，这一发现可能与胎儿心脏功能变化有关。心室舒张末期速度与心室舒张期峰值流速的比值与三尖瓣E/A比值密切相关，可用于识别孤立性SUA胎儿及正常胎儿右心室舒张功能的变化。PIV与胎儿右心室组织多普勒Tei指数密切相关，可用于识别孤立性SUA胎儿及正常胎儿的右心室整体功能。
