Devane S P, Soothill P W, Candy D C
Department of Child Health, King's College Hospital, London, UK.
Early Hum Dev. 1993 Jun;33(2):109-16. doi: 10.1016/0378-3782(93)90206-a.
Disturbed fetal gastrointestinal tract function is associated with hydramnios and may be a marker of later gastrointestinal disease. We investigated gastric motor function in the human fetus to establish the range and rate of fluctuation of gastric volume. Two pairs of orthogonal gastric diameters were measured at 5-min intervals for 1-h periods using a linear-array ultrasound scanner in 12 fetuses in late pregnancy (26-40, median 35.5 weeks gestation). A gastric volume index (GVI) was calculated. Maximum absolute gastric volume index correlated significantly with gestational age. The minimum gastric volume index as a percentage of the maximum (0-60.4%, median 28.1%) showed that marked changes in gastric dimensions occur. Filling (41.5-74.1, median 62.6 degrees) and emptying (46.6-80.9, median 61.7 degrees angles were calculated for the longest continuous filling and emptying periods using a linear model, and showed no difference in the rates of filling and emptying. Peak-to-peak and trough-to-trough durations suggested a periodicity of 35-55 min. Investigation of the development of normal fetal gastric motor activity may lead to a better understanding of postnatal adjustment to enteral feeding, and may provide a diagnostic method for antenatal diagnosis of gastrointestinal functional disturbances.
胎儿胃肠道功能紊乱与羊水过多有关，可能是后期胃肠道疾病的一个标志。我们研究了人类胎儿的胃运动功能，以确定胃容量的波动范围和速率。使用线性阵列超声扫描仪，对12例晚期妊娠胎儿（妊娠26 - 40周，中位孕周35.5周）每隔5分钟测量两对正交的胃直径，测量1小时。计算胃容量指数（GVI）。最大绝对胃容量指数与孕周显著相关。最小胃容量指数占最大胃容量指数的百分比（0 - 60.4%，中位值28.1%）表明胃尺寸发生了显著变化。使用线性模型计算最长连续充盈和排空期的充盈角度（41.5 - 74.1，中位值62.6度）和排空角度（46.6 - 80.9，中位值61.7度），结果显示充盈和排空速率没有差异。峰峰间期和谷谷间期提示周期为35 - 55分钟。对正常胎儿胃运动活动发育的研究可能有助于更好地理解出生后对肠内喂养的适应，并可能为产前诊断胃肠道功能紊乱提供一种诊断方法。
