妊娠中胎儿生长受损的血液动力学变化:系统性审查和元分析
Britt M J G Kempener1, Laura M Jorissen1,2, Eva G Mulder2
1Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, the Netherlands.
Acta obstetricia et gynecologica Scandinavica
|December 31, 2025
概括
胎儿生长受损的怀孕从第二个三个月开始显示出较高的外周总血管阻力 (TPVR) 和较低的心力输出 (CO). 严重的病例,特别是胎盘问题,具有最明显的血液动力学变化.
科学领域:
- 心血管生理学心血管生理学
- 生殖医学 生殖医学
- 胎儿的发育 胎儿的发育
背景情况:
- 中心血动力学异常可能是胎儿生长受损的先兆.
- 了解心脏输出 (CO) 和外周总血管阻力 (TPVR) 轨迹至关重要.
研究的目的:
- 为了评估心脏输出 (CO) 和总外周血管阻力 (TPVR) 轨迹在单独怀孕和没有受损的胎儿生长.
- 进行现有研究的系统审查和元分析.
主要方法:
- 在PubMed和Embase数据库中进行系统搜索 (开始 - 2023年7月).
- 包括报告CO和TPVR在胎儿生长受损的怀孕中的研究,不包括那些有先前高血压或心脏病的怀孕.
- 使用随机效应模型来计算绝对血液动力学值的元分析和严重表型的子组分析.
主要成果:
- 分析了33项涉及7816名女性的研究.
- 两组之间没有观察到非孕妇血液动力学功能的差异.
- 胎儿生长障碍与第二和第三季度TPVR升高和第三季度CO降低有关.
- 在更严重的胎儿生长限制表型中观察到更高的TPVR.
结论:
- 胎儿生长障碍与血管阻力增加和从第二个三个月开始的CO减少有关.
- 更严重的胎儿生长限制表型表现出更为血管缩的血液动力学特征.
- 未来的研究应该探索预防措施,以使血液动力学功能正常化.
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