Oosterhof H, Lander M, Aarnoudse J G
Department of Obstetrics and Gynaecology, University Hospital, Groningen, Netherlands.
Early Hum Dev. 1993 Jul;33(3):183-9. doi: 10.1016/0378-3782(93)90144-j.
Transition of fetal behavioural state 1F to 2F coincides with cardiovascular changes measured by Doppler velocimetry e.g. a decrease in pulsatility index (PI) in the internal carotid arteries and in the descending aorta, indicating redistribution of blood flow. Recently, we reported a considerable reduction in fetal urine production rate of 47% during fetal behavioural state 2F as compared to 1F. It was suggested that this reduction is caused by an increase in renal vascular resistance during 2F. Using Doppler ultrasound, flow velocity waveforms (FVW) of fetal renal arteries were recorded during behavioural states 1F and 2F. Fetal behavioural states 1F and 2F were assessed by recording fetal heart rate pattern, eye movements and body movements. The PI of the renal artery FVWs were calculated as an index of renal vascular resistance to blood flow. Fifteen healthy pregnant women between 36 and 40 weeks gestational age were studied and the relationship between fetal renal vascular resistance to blood flow and behavioural states was determined. We found that PI values in the renal arteries did not change relative to behavioural state 1F and 2F. These findings suggest that renal vascular resistance to blood flow is not appreciably different in 1F and 2F. This is in contrast with urine production rate which is almost reduced by half during 2F in the near term fetus.
胎儿行为状态从1F转变为2F与通过多普勒测速法测量的心血管变化同时发生，例如颈内动脉和降主动脉的搏动指数（PI）降低，表明血流重新分布。最近，我们报告称，与1F相比，胎儿行为状态2F期间胎儿尿量生成率大幅降低了47%。有人认为这种降低是由2F期间肾血管阻力增加所致。利用多普勒超声，在行为状态1F和2F期间记录胎儿肾动脉的血流速度波形（FVW）。通过记录胎儿心率模式、眼球运动和身体运动来评估胎儿行为状态1F和2F。计算肾动脉FVW的PI作为肾血管对血流阻力的指标。对15名孕龄在36至40周之间的健康孕妇进行了研究，并确定了胎儿肾血管对血流的阻力与行为状态之间的关系。我们发现，相对于行为状态1F和2F，肾动脉的PI值没有变化。这些发现表明，1F和2F期间肾血管对血流的阻力没有明显差异。这与近期胎儿在2F期间尿量生成率几乎减半的情况形成对比。
