Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.
Medical Faculty, Medical University of Lodz, Lodz, Poland.
J Perinat Med. 2021 Feb 11;49(5):590-595. doi: 10.1515/jpm-2020-0316. Print 2021 Jun 25.
The subject of our analysis is the influence of umbilical cord collision around the fetal neck on the fetal heart function and cerebral circulation.
Our study was carried out on a group of 115 fetuses from single pregnancies with physiological course, during the 15th to 40th week of pregnancy. In our analysis, we examined the following parameters: Tei index for right ventricle, Tei index for left ventricle with Tei index components: isovolumetric contraction time, isovolumetric relaxation time, ejection time and cardiothoracic area ratio, middle cerebral artery peak systolic velocity (PS MCA), middle cerebral artery pulsatility index (PI MCA). Gestational age in our study was: 28+2±34. The study group of patients with fetal umbilical cord around neck group (fUCAN) included 38 fetuses (20 males, 18 females). The control group of patients with no fetal umbilical cord around neck group (NfUCAN) included 77 fetuses (43 males, 34 females).
In our study, we found no significant differences in the values obtained: Tei LV in fUCAN: 0.5±0.1 vs. in NfUCAN: 0.5±0.1; p=0.42), Tei RV in fUCAN: 0.5±0.2 vs. in NfUCAN: 0.4±0.1; (p=0.2). Tricuspid valve regurgitation-TR was observed with the following frequency: fUCAN: 7/38, 18% vs. NfUCAN: 13/77, 17%; p=0.8. MCA PS in study fUCAN group was significantly higher than in NfUCAN (40.2±11.5 vs. 32.5±9.5; p=0.003), although other hemodynamic and clinical variables did not differ between the study and control groups.
The fetal nuchal umbilical cord collision did not affect the fetal heart function expressed as Tei index, at the time of fetal heart examination (at mean gestational age 29+4 weeks). The fUCAN group presented elevated PS MCA, which was not related to other hemodynamic and clinical variables between the study and control groups.
我们分析的主题是胎儿颈部周围脐带缠绕对胎儿心脏功能和脑循环的影响。
我们的研究对象是 115 名单胎妊娠且妊娠过程正常的胎儿，其妊娠周数为 15 至 40 周。在分析中，我们检查了以下参数：右心室的 Tei 指数、左心室的 Tei 指数及其等容收缩时间、等容舒张时间、射血时间和心胸面积比、大脑中动脉收缩期峰值速度（PS MCA）、大脑中动脉搏动指数（PI MCA）。在我们的研究中，胎龄为 28+2±34。脐带绕颈组（fUCAN）患者的研究组包括 38 名胎儿（男 20 名，女 18 名）。无脐带绕颈组（NfUCAN）患者的对照组包括 77 名胎儿（男 43 名，女 34 名）。
在我们的研究中，我们发现以下参数的值没有显著差异：fUCAN 中的 Tei LV：0.5±0.1 与 NfUCAN 中的 Tei LV：0.5±0.1（p=0.42）；fUCAN 中的 Tei RV：0.5±0.2 与 NfUCAN 中的 Tei RV：0.4±0.1（p=0.2）。三尖瓣反流-TR 的发生频率为：fUCAN：7/38，18%与 NfUCAN：13/77，17%（p=0.8）。研究组的 MCA PS 明显高于对照组（40.2±11.5 与 32.5±9.5；p=0.003），尽管研究组和对照组之间的其他血流动力学和临床变量没有差异。
胎儿颈部脐带缠绕在胎儿心脏检查时（平均胎龄 29+4 周）并未影响 Tei 指数所表示的胎儿心脏功能。fUCAN 组的 MCA PS 升高，但与研究组和对照组之间的其他血流动力学和临床变量无关。
