胎儿降主动脉多普勒超声：评估脐动脉不一致妊娠胎盘血流阻力的客观工具。
Doppler Ultrasound of the Fetal Descending Aorta: An Objective Tool to Assess Placental Blood Flow Resistance in Pregnancies With Discordant Umbilical Arteries.
机构信息
Department of Chemistry, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada.
Mount Sinai Hospital, Toronto, Ontario, Canada.
出版信息
J Ultrasound Med. 2022 Apr;41(4):899-905. doi: 10.1002/jum.15773. Epub 2021 Jul 6.
OBJECTIVES
To determine the relationship between blood flow in the fetal descending aorta and discordant umbilical arteries (UAs).
METHODS
Pulsed wave Doppler of both UAs and the descending aorta was performed at 4-weekly intervals between 14 and 40 weeks of gestation in 209 pregnant women. In datasets with discordant UAs, a linear mixed effects model was used to determine the categorical relationship between the UA pulsatility index (PI) (high, low and average) and the descending aorta PI.
RESULTS
Of the 209 cases, 81 had a discordance of greater than 25% in UA PI during one of their visits. There were no differences in birth outcomes between the groups with concordant and discordant UA PIs. In the cases with discordant UA PIs, the descending aorta PI was most strongly associated with both the average UA PI (P = .008), and with the UA with the lower PI (P = .008).
CONCLUSIONS
The relationship between blood flow in the descending aorta and UAs is consistent with the law for combining resistances in parallel. Measurements of the descending aorta PI, particularly in a scenario with discordant UAs, may inform the stability of the feto-placental circulation where discordant UA PIs are found.
目的
确定胎儿降主动脉血流与脐动脉（UA）不一致之间的关系。
方法
在 209 名孕妇中，在妊娠 14 至 40 周期间，每 4 周进行一次双侧 UA 和降主动脉的脉冲波多普勒检查。在 UA 搏动指数（PI）不一致的数据集，采用线性混合效应模型确定 UA PI（高、低和平均）与降主动脉 PI 的分类关系。
结果
在 209 例中，81 例在一次就诊时 UA PI 差异大于 25%。UA PI 一致和不一致组之间的出生结局无差异。在 UA PI 不一致的情况下，降主动脉 PI 与平均 UA PI（P=0.008）和较低 PI 的 UA（P=0.008）最密切相关。
结论
降主动脉血流与 UA 之间的关系符合并联阻力的组合定律。降主动脉 PI 的测量，特别是在 UA 不一致的情况下，可能会反映出存在 UA PI 不一致时胎-胎盘循环的稳定性。
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