Fouron J C, Teyssier G, Shalaby L, Lessard M, van Doesburg N H
Department of Pediatrics, St. Justine Hospital, University of Montreal, Canada.
Am J Perinatol. 1993 May;10(3):197-207. doi: 10.1055/s-2007-994718.
Blood flow velocimetry studies in animal fetuses with reverse diastolic flow in the umbilical artery have shown marked changes in the fetal central circulation characterized by a retrograde diastolic flow in the descending aorta, and as far as the aortic arch, along with a significant forward diastolic flow in the arteries going to the brain. Documentation and the implications of this phenomenon in human fetuses, to date, have not been reported. Doppler echographic evaluations of the diastolic patterns in the umbilical artery, descending aorta, the aortic arch, and the common carotid artery were performed on 5 fetuses in whom reverse diastolic flow was observed in the umbilical artery. In all five cases reverse diastolic flow was observed not only in the umbilical artery but also in the aortic arch. In the carotid artery, however, a forward diastolic flow was always recorded. It can be concluded, by inference, that in these fetuses, the area of lowest resistance was no longer the placenta, as seen in normal conditions, but the cerebral circulation. Furthermore, in four fetuses the retrograde component of the flow profiles was more prominent in the aortic arch compared with the descending aorta, suggesting that, in diastole, blood was coming from the pulmonary artery through the ductus arteriosus.
对脐动脉存在舒张期反向血流的动物胎儿进行的血流速度测定研究显示，胎儿中心循环有显著变化，其特征为降主动脉直至主动脉弓出现舒张期逆向血流，同时供应脑部的动脉出现明显的舒张期正向血流。迄今为止，尚未有关于该现象在人类胎儿中的记录及相关影响的报道。对5例脐动脉出现舒张期反向血流的胎儿进行了脐动脉、降主动脉、主动脉弓及颈总动脉舒张期血流模式的多普勒超声评估。在所有5例病例中，不仅在脐动脉，而且在主动脉弓均观察到舒张期反向血流。然而，在颈动脉总是记录到舒张期正向血流。由此可以推断，在这些胎儿中，阻力最低的区域不再像正常情况下那样是胎盘，而是脑循环。此外，在4例胎儿中，与降主动脉相比，主动脉弓血流频谱的逆向成分更为突出, 这表明在舒张期，血液是通过动脉导管从肺动脉而来。
