Mitra S C, Ganesh V, Apuzzio J J
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark.
Am J Obstet Gynecol. 1994 Dec;171(6):1556-9. doi: 10.1016/0002-9378(94)90401-4.
Our purpose was to study the short-term effect of maternal cocaine abuse on blood flow of the fetal kidney and the fetal hourly urine output.
Thirty-three pregnant patients of various gestational ages with a history of cocaine abuse were studied. Patients were included if the urine specimen was positive for cocaine on the day of study. Patients were excluded if the urine specimen was positive for any other vasoactive substances or medications. Color and pulsed wave Doppler studies were used to obtain the flow velocity waveform of the fetal renal artery. The resistance index was calculated from systolic and diastolic values of flow velocity waveforms, Longitudinal, transverse, and anteroposterior diameters of the fetal urinary bladder were measured from transverse and coronal images at their maximum diameters, and the bladder volume was calculated. The hourly urine output of the fetus was measured from the difference in the bladder volume at half-hour intervals. As controls, 110 normal pregnancies between 19 and 40 weeks were similarly studied for normal values. The resistance index of the fetal renal artery and the hourly fetal urine output of the two groups were compared.
The resistance index of the fetal renal artery of normal pregnancies had a negative association with gestational age (p < 0.05). Cocaine-exposed fetuses had a significantly higher resistance index of the renal artery (p < 0.01) than did normal fetuses of corresponding gestational ages. A decrease in the hourly urine output of cocaine-exposed fetuses was observed, compared with normal controls of corresponding gestational ages (p < 0.001).
The resistance index values of fetal renal artery and fetal urine output were affected by maternal cocaine abuse.
我们的目的是研究母亲滥用可卡因对胎儿肾脏血流及胎儿每小时尿量的短期影响。
对33例不同孕周且有可卡因滥用史的孕妇进行了研究。如果研究当天尿液标本可卡因检测呈阳性，则纳入研究对象。如果尿液标本对任何其他血管活性物质或药物检测呈阳性，则排除该患者。使用彩色和脉冲波多普勒研究获取胎儿肾动脉的血流速度波形。根据血流速度波形的收缩期和舒张期值计算阻力指数。从横向和冠状图像上测量胎儿膀胱的纵向、横向和前后径的最大直径，并计算膀胱体积。通过半小时间隔内膀胱体积的差异来测量胎儿的每小时尿量。作为对照，对110例孕19至40周的正常妊娠进行了类似研究以获取正常值。比较两组胎儿肾动脉的阻力指数和胎儿每小时尿量。
正常妊娠胎儿肾动脉的阻力指数与孕周呈负相关（p<0.05）。与相应孕周的正常胎儿相比，暴露于可卡因的胎儿肾动脉阻力指数显著更高（p<0.01）。与相应孕周的正常对照组相比，观察到暴露于可卡因的胎儿每小时尿量减少（p<0.001）。
母亲滥用可卡因会影响胎儿肾动脉阻力指数值和胎儿尿量。
