Department of Obstetrics and Gynaecology, Sint Lucas Ziekenhuis, Gent, Belgium; Department of Physiology, Hasselt University, Hasselt, Belgium.
Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Diepenbeek, Belgium.
Ultrasound Med Biol. 2022 May;48(5):895-900. doi: 10.1016/j.ultrasmedbio.2022.01.012. Epub 2022 Mar 1.
Standardized combined Doppler-electrocardiogram assessment was performed longitudinally at three different locations of internal jugular veins between 12 wk of gestation and 6 wk postnatally in 24 uncomplicated pregnancies. All images were classified as typical or non-typical based on the presence of the physiologic deflections A, X, H and C. Linear mixed models with random intercepts of typical images were used to investigate gestational changes in venous pulse transit time and venous impedance index. Unequivocal identification of venous pulse transit time and venous impedance index was possible in 2617 of 3798 (69%) and 2234 of 3798 (59%) images, respectively. The best identification rate (80%, 1018/1266) was at the right distal internal jugular vein. Venous pulse transit time increased with gestational age at all locations; venous impedance index decreased at the right sided internal jugular vein. Maternal jugular venous pulse waveform by combined Doppler-electrocardiogram allows unequivocal identification of A-deflection and calculation of venous pulse transit time and venous impedance index in around two-thirds of assessments, with the highest success rate at the right distal internal jugular vein. Gestational evolutions of venous pulse transit time and venous impedance index are similar to those reported at the level of renal interlobar and hepatic veins.
在 24 例无并发症的妊娠中，在 12 孕周至产后 6 周期间，在颈内静脉的三个不同部位进行了标准化的联合多普勒-心电图评估。所有图像均根据生理偏转 A、X、H 和 C 的存在分为典型或非典型。使用具有典型图像随机截距的线性混合模型，研究静脉脉搏传递时间和静脉阻抗指数的妊娠变化。在 3798 个图像中的 2617 个（69%）和 3798 个图像中的 2234 个（59%）中可以明确识别静脉脉搏传递时间和静脉阻抗指数。最佳识别率（80%，1018/1266）出现在右侧颈内静脉远端。在所有部位，静脉脉搏传递时间随胎龄增加而增加；右侧颈内静脉的静脉阻抗指数降低。联合多普勒-心电图的颈内静脉脉搏波形可明确识别 A 偏转，并计算静脉脉搏传递时间和静脉阻抗指数，约三分之二的评估中可明确识别，在右侧颈内静脉远端的成功率最高。静脉脉搏传递时间和静脉阻抗指数的妊娠变化与肾叶间和肝静脉水平报告的变化相似。
