Faber R, Springer C, Stepan H, Viehweg B
Universitäts-Frauenklinik Leipzig.
Zentralbl Gynakol. 1997;119(2):60-5.
We investigated 69 healthy women with normal pregnancy and delivery in order to establish normal values for the second trimester of gestation. In a cross-sectional study we measured the pulsatility index (PI), the maximal systolic velocity (V-MAX) and the mean velocity (V-MEAN) in the uterine arteries (UAA), the umbilical artery (UA), the fetal thoracic aorta (FTA) and the middle cerebral artery (MCA) from the 14th to the 24th week of gestation. A regression analysis shows a significant slope of the PI of UAA and UA (p < 0.01), whereas in contrast to the UA there is no significant difference of the median values of the UAA-PI from the 18th week of gestation. With progressive gestation V-MEAN of UAA increases more (p < 0.001) than V-MAX (p < 0.05) as a result of the increasing diastolic blood flow. In the UA there is also a significant rising trend of V-MAX and V-MEAN (p < 0.0001). No significant changes of the PI of FTA and MCA are seen, although there is a slight increasing trend. After the 20th week in the MCA a marked tendency to high PI-values is observed, whereas there is a change between different flowpatterns prior to the 20th week. V-MAX and V-MEAN of FTA increases significantly, but there is no change in the MCA. Our results for UAA and UA correspond to the known morphologic changes in the utero- and fetoplacental vessels in the second trimester and are comparable to other results. Particularly the physiology of the cerebral perfusion needs to be investigated more intensively. These normal values provide a good basis for early and complex assessment of a disturbed perfusion in the second trimester.
我们对69名妊娠及分娩正常的健康女性进行了研究,以确定妊娠中期的正常值。在一项横断面研究中,我们测量了妊娠14至24周时子宫动脉(UAA)、脐动脉(UA)、胎儿胸主动脉(FTA)和大脑中动脉(MCA)的搏动指数(PI)、最大收缩速度(V-MAX)和平均速度(V-MEAN)。回归分析显示UAA和UA的PI有显著斜率(p < 0.01),而与UA不同,从妊娠第18周起UAA-PI的中位数无显著差异。随着妊娠进展,由于舒张期血流增加,UAA的V-MEAN比V-MAX增加更多(p < 0.001)(p < 0.05)。在UA中,V-MAX和V-MEAN也有显著上升趋势(p < 0.0001)。尽管FTA和MCA的PI有轻微上升趋势,但未见显著变化。在MCA中,20周后观察到明显的高PI值倾向,而在20周前不同血流模式之间存在变化。FTA的V-MAX和V-MEAN显著增加,但MCA无变化。我们关于UAA和UA的结果与妊娠中期子宫和胎儿胎盘血管已知的形态学变化相符,且与其他结果可比。特别是大脑灌注的生理学需要更深入地研究。这些正常值为妊娠中期灌注紊乱的早期和综合评估提供了良好基础。