在高风险怀孕中,如果没有增加中央静脉压力的迹象,静脉管就会打开
Marta I Sekielska-Domanowska1, Anna Iwanicka-Piotrowska2, Mariusz Dubiel2
1Department of Obstetrics and Gynecology, Jan Biziel University Hospital No. 2, Bydgoszcz, Poland, Poland. marta.sekielska@gmail.com.
Ginekologia polska
|July 7, 2023
概括
胎儿静脉管道血流速度的变化可能不仅仅表明缺氧期间中心静脉压力增加或胎儿心脏应变. 这项研究表明,其他因素可能与中度胎儿缺氧有关.
科学领域:
- 胎儿医学 胎儿医学
- 心血管生理学心血管生理学
- 诊断性的超声波检查
背景情况:
- 传统上,胎儿静脉管 (ductus venosus) 的舒张血速变化是由于胎儿心脏压力在缺氧或心力衰竭期间增加的中央静脉压力而导致的.
- 最近的观察表明,静脉管的变化 血流速度可以发生在没有明显的胎儿心脏紧张的情况下.
研究的目的:
- 为了研究右肝静脉中血液速度之间的关系,作为中央静脉压力的标记,以及通道静脉血液速度的变化.
- 在怀疑生长限制的胎儿中区分改变静脉管道血流的原因.
主要方法:
- 用多普勒超声波评估50例怀孕,怀疑胎儿生长受限.
- 在胎儿静脉管,右肝静脉和静脉中测量了血液速度.
- 通过子宫动脉,动脉和中脑动脉多普勒对胎盘和胎儿的血液循环进行了评估.
主要成果:
- 在5个胎儿中检测到异常的管道静脉血流速度.
- 没有一个有异常通道静脉速度的胎儿在右肝静脉中表现出异常脉动性.
- 在相当数量的胎儿中观察到动脉脉动率增加和大脑节省的迹象.
结论:
- 静脉管的开放不仅与胎儿的心脏应变有关.
- 在中度胎儿缺氧时,由于中心静脉压力升高,静脉管道可能不会主要开放.
- 增加胎儿心脏应变可能代表慢性胎儿缺氧的晚期阶段.
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