Stampalija Tamara, Monasta Lorenzo, Barbieri Moira, Chiodo Antonella, Quadrifoglio Mariachiara, Fantasia Ilaria, Bello Leila Lo, Barresi Valentina, Ottaviani Chiara, Di Martino Daniela Denis, Marangon Eleonora, Travan Laura, Bernardon Maria, Ferrazzi Enrico Maria
Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy.
Eur J Obstet Gynecol Reprod Biol. 2022 May;272:182-187. doi: 10.1016/j.ejogrb.2022.03.032. Epub 2022 Mar 15.
To investigate the umbilical vein and uterine arteries blood flow volume (UV-Q, UtA-Q) in late-term pregnancies.
This was a prospective observational cohort study of singleton pregnancies ≥40 + 0 weeks in which UV-Q and UtA-Q, both absolute and normalized for estimated fetal weight (EFW) values, were evaluated in relation to AC drop of ≥20 percentiles from 20 weeks to term, Doppler signs of fetal cerebral blood flow redistribution and composite adverse perinatal outcome. The presence of neonatal hypoglycaemia and the need of formula milk supplementation were also examined.
The study population comprised 200 women. Fetuses with AC drop (n = 34) had a significantly lower UV-Q and UV-Q/EFW than fetuses without AC drop (n = 166): median UV-Q 184 ml/min (IQR 143-225) vs 233 ml/min (IQR 181-277), p = 0.0006; median UV-Q/EFW 55 ml/min/kg (IQR 42-66) vs 63 ml/min/kg (IQR 48-74), p = 0.03. Fetuses with cerebral blood flow redistribution (n = 48) had a significantly lower UV-Q and UV-Q/EFW than those without (n = 134): median UV-Q 210 ml/min (IQR 155-263) vs 236 ml/min (IQR 184-278), p = 0.04; median UV-Q/EFV 58 ml/min/kg (IQR 45-70) vs 65 ml/min/kg (IQR 50-76), p = 0.04. There was a significant moderate correlation between middle cerebral artery pulsatility index (MCA-PI) and UV-Q and UV-Q/EFW (Spearman Rho -0.20 and -0.20; p = 0.008 and p = 0.006).
The umbilical vein blood flow volume might have a potential role to identify fetuses with stunted growth in late-term pregnancies.
研究晚期妊娠时脐静脉和子宫动脉的血流量（UV-Q、UtA-Q）。
这是一项对单胎妊娠≥40 + 0周的前瞻性观察队列研究，评估了UV-Q和UtA-Q的绝对值以及根据估计胎儿体重（EFW）值进行标准化后的数值，与孕20周时到足月时腹围下降≥20百分位数、胎儿脑血流再分布的多普勒征象以及围产期综合不良结局之间的关系。还检查了新生儿低血糖的存在情况以及配方奶补充的需求。
研究人群包括200名女性。腹围下降的胎儿（n = 34）的UV-Q和UV-Q/EFW显著低于腹围未下降的胎儿（n = 166）：UV-Q中位数为184 ml/min（四分位间距143 - 225），而后者为233 ml/min（四分位间距181 - 277），p = 0.0006；UV-Q/EFW中位数为55 ml/min/kg（四分位间距42 - 66），而后者为63 ml/min/kg（四分位间距48 - 74），p = 0.03。脑血流再分布的胎儿（n = 48）的UV-Q和UV-Q/EFW显著低于未出现脑血流再分布的胎儿（n = 134）：UV-Q中位数为210 ml/min（四分位间距155 - 263），而后者为236 ml/min（四分位间距184 - 278），p = 0.04；UV-Q/EFV中位数为58 ml/min/kg（四分位间距45 - 70），而后者为65 ml/min/kg（四分位间距50 - 76），p = 0.04。大脑中动脉搏动指数（MCA-PI）与UV-Q和UV-Q/EFW之间存在显著的中度相关性（斯皮尔曼等级相关系数分别为-0.20和-0.20；p = 0.008和p = 0.006）。
脐静脉血流量可能在识别晚期妊娠中生长受限的胎儿方面具有潜在作用。
