Milliez J, Blanchard D, Diebold B, Vacher-Lavenu M C, Péronneau P, Sureau C
Presse Med. 1983 Jun 18;12(26):1649-53.
Foetal blood velocity wave forms, as recorded in chorionic vessels by pulsed Doppler ultrasonography, reflect vascular resistance in foetal placental circulation. The minimal-to-maximal velocity ratio provides an index of vascular conductance; the higher the minimal velocity (positive forward diastolic blood flow), the lower the vascular resistance. In the present study, this index was the same in pregnant women with normal blood pressure (n = 19) and in those with pregnancy-induced hypertension (n = 12); however, it was significantly lowered (p less than 0.001) in pregnant women with essential hypertension (n = 9). In the population of women with normal blood pressure and pregnancy-induced hypertension, a positive correlation (r = 0.71), was found between index value and gestational age, indicating a progressive fall in placental vascular resistance. All placentas from these 31 women were histologically normal except two which showed one single marginal infarct less than 1 cm in diameter. In the group of women with essential hypertension, the 6 placentas examined were pathological, with multiple chronic infarcts, placental growth retardation and maceration. Thus, pulsed Doppler ultrasonography should be used for early detection of placental vascular damage and for improved surveillance of pregnancies complicated by maternal vascular diseases.
通过脉冲多普勒超声检查记录的绒毛膜血管中的胎儿血流速度波形，反映了胎儿胎盘循环中的血管阻力。最小至最大速度比提供了血管传导性的指标；最小速度（正向舒张期血流为正）越高，血管阻力越低。在本研究中，血压正常的孕妇（n = 19）和妊娠高血压孕妇（n = 12）的该指标相同；然而，原发性高血压孕妇（n = 9）的该指标显著降低（p小于0.001）。在血压正常和妊娠高血压的女性人群中，指标值与孕周之间存在正相关（r = 0.71），表明胎盘血管阻力逐渐下降。这31名女性的所有胎盘组织学检查均正常，只有两片胎盘显示有单个直径小于1厘米的边缘梗死灶。在原发性高血压女性组中，检查的6片胎盘均为病理性，有多处慢性梗死灶、胎盘生长受限和浸软。因此，脉冲多普勒超声检查应用于早期发现胎盘血管损伤，并改善对合并母体血管疾病的妊娠的监测。
