晚发型胎儿生长受限的脐静脉容积血流。

Umbilical Venous Volume Flow in Late-Onset Fetal Growth Restriction.

机构信息

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA.

Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.

出版信息

J Ultrasound Med. 2023 Jan;42(1):173-183. doi: 10.1002/jum.15993. Epub 2022 Apr 22.

DOI:10.1002/jum.15993

PMID:35451119

Abstract

OBJECTIVES

Umbilical vein flow (UVF) is reduced in fetal growth restriction (FGR). We compared absolute and size-adjusted UVF (estimated fetal weight [EFW] and abdominal circumference [AC]) and rates of abnormal UVF parameters (<10th percentile) among FGR fetuses meeting Delphi criteria (FGR-D) against small for gestational age (SGA) fetuses and appropriate for gestational age (AGA) controls.

METHODS

Absolute UVF, UVF/EFW, and UVF/AC were compared between 73 FGR pregnancies (35 FGR-D, 38 SGA) and 108 AGA controls. Rates of abnormal UVF were compared to abnormal umbilical artery pulsatility index (UAPI). Independent samples t-tests, Mann-Whitney U, odds ratio (OR), chi-squared, and Fisher's exact tests were used as appropriate.

RESULTS

Mean absolute UVF was significantly decreased in FGR-D compared to AGA (P = .0147), but not between SGA and AGA fetuses. The incidence of both abnormal absolute UVF and UVF/AC values (<10th centile) was higher among late-onset FGR fetuses versus AGA fetuses (UVF: OR 2.7, confidence interval [CI] 1.37-5.4; UVF/AC: OR 2.73, CI 1.37-5.4). UVF was more frequently abnormal than UAPI and in only two fetuses were both Doppler values abnormal.

CONCLUSION

Absolute UVF is altered in late-onset FGR, and most pronounced among FGR-D. UVF may provide additional insight into fetal compromise in those affected by growth restriction.

摘要

目的

胎儿生长受限（FGR）患者的脐静脉血流（UVF）减少。我们比较了符合 Delphi 标准（FGR-D）的 FGR 胎儿与小于胎龄儿（SGA）和适于胎龄儿（AGA）对照组之间的绝对和大小调整后的 UVF（估计胎儿体重 [EFW] 和腹围 [AC]）以及异常 UVF 参数（<第 10 百分位数）的发生率。

方法

在 73 例 FGR 妊娠（35 例 FGR-D，38 例 SGA）和 108 例 AGA 对照组中比较了绝对 UVF、UVF/EFW 和 UVF/AC。异常 UVF 的发生率与异常脐动脉搏动指数（UAPI）进行了比较。使用独立样本 t 检验、Mann-Whitney U 检验、优势比（OR）、卡方检验和 Fisher 精确检验。

结果

与 AGA 相比，FGR-D 的平均绝对 UVF 明显降低（P=0.0147），但 SGA 与 AGA 胎儿之间无差异。与 AGA 胎儿相比，晚发型 FGR 胎儿异常绝对 UVF 和 UVF/AC 值（<第 10 百分位数）的发生率更高（UVF：OR 2.7，置信区间 [CI] 1.37-5.4；UVF/AC：OR 2.73，CI 1.37-5.4）。异常 UVF 比 UAPI 更常见，只有两例胎儿两种多普勒值均异常。