Mulder E J, Leiblum D M, Visser G H
Department of Obstetrics and Gynaecology, University Hospital, Utrecht, Netherlands.
Early Hum Dev. 1995 Nov 24;43(3):225-32. doi: 10.1016/0378-3782(95)01681-3.
In type-1 diabetic pregnancy, the occurrence of fetal breathing movements (FBM) was studied in relation to the fetal heart rate patterns (HRPs) A and B and to Braxton Hicks' contractions. Simultaneous 2-h recordings of fetal heart rate and body, eye and breathing movements were available for analysis (n = 44). These recordings were made in 20 fetuses of diabetic women at 32-38 weeks of gestation. Uterine activity was monitored at 36 and 38 weeks. For all recordings combined, the median incidences of FBM during HRPs A and B were 23% and 41%, respectively (NS). At low overall breathing activity (< 50% of total observation time), FBM were more numerous during HRP B than during HRP A in 83% of the recordings. However, if the overall breathing activity exceeded 50% of time FBM were preferentially made during HRP A in 93% of the recordings. This relationship was most pronounced at 38 weeks. These results corroborate our previous findings in the healthy near-term fetus. They show even more clearly that the state-dependent occurrence of FBM depends on the fetus' drive to breathe. During the recordings, breathing activity remained unchanged at all gestational ages studied, in contrast to the gradual decline in FBM seen in normal pregnancy. Braxton Hicks's contractions had no effect on FBM, which differs from the specific distribution of FBM during uterine contractions as previously found in uncomplicated pregnancies. We conclude that FBM in late diabetic pregnancy are not influenced by Braxton Hicks' contractions and that they do not show a clear-cut state-dependency. The (neural) mechanism underlying FBM differs from that in normal pregnancy.
在1型糖尿病孕妇中，研究了胎儿呼吸运动（FBM）与胎儿心率模式（HRP）A和B以及与布拉克斯顿·希克斯宫缩的关系。同时有2小时的胎儿心率、身体、眼睛和呼吸运动记录可供分析（n = 44）。这些记录是在20名妊娠32 - 38周的糖尿病孕妇的胎儿身上进行的。在妊娠36周和38周时监测子宫活动。对于所有合并的记录，HRP A和B期间FBM的中位发生率分别为23%和41%（无显著性差异）。在总体呼吸活动较低（<总观察时间的50%）时，83%的记录中HRP B期间的FBM比HRP A期间更多。然而，如果总体呼吸活动超过时间的50%，93%的记录中FBM在HRP A期间更频繁出现。这种关系在38周时最为明显。这些结果证实了我们之前在健康近足月胎儿中的发现。它们更清楚地表明，FBM的状态依赖性发生取决于胎儿的呼吸驱动力。在记录过程中，在所研究的所有孕周，呼吸活动保持不变，这与正常妊娠中FBM逐渐减少形成对比。布拉克斯顿·希克斯宫缩对FBM没有影响，这与之前在无并发症妊娠中发现的子宫收缩期间FBM的特定分布不同。我们得出结论，晚期糖尿病妊娠中的FBM不受布拉克斯顿·希克斯宫缩的影响，且它们没有显示出明确的状态依赖性。FBM背后的（神经）机制与正常妊娠不同。
