de Koekkoek-Doll P K, Stijnen T, Wladimiroff J W
Department of Obstetrics and Gynaecology, Erasmus University, Rotterdam, The Netherlands.
Early Hum Dev. 1994 Jul;38(1):27-34. doi: 10.1016/0378-3782(94)90047-7.
In 14 normal pregnancies at 30-32 weeks of gestation, bloodflow velocity waveforms in the fetal renal artery and fetal micturition were studied in relation to fetal heart rate pattern (FHRP) and fetal eye movements. PI in the fetal renal artery was significantly lower in the presence of FHRP-B and eye movements separately and in combination compared with FHRP-A and absent eye movements separately and in combination. Fetal urinary output was higher in the absence of fetal eye movements. There was an inverse relationship between renal artery PI and fetal heart rate. However, since mean fetal heart rate in the various state variables was not essentially different, no standardization for heart rate was necessary. No correlation existed between renal artery PI and fetal urinary production rate. It can be concluded that in the normal fetus at 30-32 weeks of gestation, renal artery PI demonstrates a significant reduction in the presence of FHRP-B and fetal eye movements separately and in combination, suggesting reduced downstream impedance at renal level. However, the decrease in fetal micturition in the presence of fetal eye movements, suggests that reduced urinary output is determined by changes in fetal central nervous system activity rather than by changes in fetal renal perfusion.
在14例妊娠30 - 32周的正常孕妇中，研究了胎儿肾动脉血流速度波形和胎儿排尿与胎儿心率模式（FHRP）及胎儿眼动的关系。与单独及联合出现FHRP - A和无眼动相比，单独及联合出现FHRP - B和眼动时，胎儿肾动脉搏动指数（PI）显著降低。无胎儿眼动时胎儿尿量较高。肾动脉PI与胎儿心率呈负相关。然而，由于各状态变量下胎儿平均心率无本质差异，无需对心率进行标准化。肾动脉PI与胎儿尿生成率之间无相关性。可以得出结论，在妊娠30 - 32周的正常胎儿中，单独及联合出现FHRP - B和胎儿眼动时，肾动脉PI显著降低，提示肾水平下游阻抗降低。然而，有胎儿眼动时胎儿排尿减少，提示尿量减少是由胎儿中枢神经系统活动变化而非胎儿肾灌注变化决定的。
