Centro de Atenção à Mulher, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brasil.
Escola de Saúde e Ciências da Vida, Universidade Católica de Pernambuco, Recife, PE, Brasil.
Braz J Med Biol Res. 2023 Nov 13;56:e13018. doi: 10.1590/1414-431X2023e13018. eCollection 2023.
The aim of this study was to characterize the normality of the fetal circulatory system through the time between ventricular systoles of the ductus venosus in the three gestational trimesters in healthy fetuses using nonlinear methods of the complexity of the signal. A prospective cohort study was conducted at the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) from December 2019 to May 2020. Pregnant women between 11 and 14 weeks, with intrauterine pregnancy and healthy fetus were included. Patients with multiple gestation, positive screening for congenital malformation, including heart disease, and under 18 years of age were excluded. Doppler velocimetry ultrasonography of the ductus venosus was performed between the 11th and 14th weeks, 20th and 24th weeks, and 28th and 32nd weeks of gestation, and then the sound signal was extracted and segmented from the videos. To compare the means between the gestational trimesters of the approximate entropy (ApEn) and Lempel-Ziv complexity (CLZ) of the time between ventricular systoles, the Friedman test was used, with a significance level of 5%. No statistically significant difference was found between the 1st, 2nd, and 3rd trimesters regarding the mean ApEn (P=0.281) and CLZ (P=0.595) of the time between ventricular systoles of the ductus venosus. Ductus venosus systolic time was not sensitive to differentiate fetal cardiovascular dynamics between gestational trimesters. This study pioneered the characterization of cardiovascular normality by nonlinear parameters of the fetal ductus venosus in all three trimesters.
本研究旨在通过信号复杂度的非线性方法，描述正常胎儿在三个妊娠期的静脉导管心室收缩之间的时间。这是一项在 2019 年 12 月至 2020 年 5 月期间于费尔南多·菲格雷多综合医学研究所（IMIP）进行的前瞻性队列研究。纳入的孕妇处于 11 至 14 周，妊娠宫内且胎儿健康。排除多胎妊娠、先天性畸形筛查阳性（包括心脏病）和年龄小于 18 岁的患者。在妊娠 11 至 14 周、20 至 24 周和 28 至 32 周时进行静脉导管多普勒速度超声检查，然后从视频中提取和分段声音信号。为了比较近似熵（ApEn）和心室收缩之间时间的 Lempel-Ziv 复杂度（CLZ）的妊娠期平均值，使用 Friedman 检验，显著性水平为 5%。静脉导管心室收缩之间的 ApEn（P=0.281）和 CLZ（P=0.595）的平均值在第 1、2 和 3 个妊娠期之间没有统计学差异。静脉导管收缩时间不能敏感地区分胎儿心血管动力学在不同的妊娠期。本研究率先通过静脉导管的非线性参数来描述所有三个妊娠期的心血管正常性。
