Middle cerebral artery velocimetry as a predictor of hypoxemia in fetuses with increased resistance to blood flow in the umbilical artery

被引：59

作者：

Dubiel, M ^{[1
]}

Gudmundsson, S ^{[1
]}

Gunnarsson, G ^{[1
]}

Marsal, K ^{[1
]}

机构：

[1] LUND UNIV,MALMO UNIV HOSP,DEPT OBSTET & GYNECOL,S-20502 MALMO,SWEDEN

来源：

EARLY HUMAN DEVELOPMENT | 1997年 / 47卷 / 02期

关键词：

middle cerebral artery; umbilical artery; cerebro-placental ratio; brain-sparing; operative delivery for fetal distress; hypoxemia; labour;

D O I：

10.1016/S0378-3782(96)01777-X

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

About half of all fetuses with increased resistance to blood how, but with still detectable diastolic blood velocity in the umbilical artery (UA), show signs of imminent asphyxia during labour indicating a need for operative delivery. Fetal brain-sparing during hypoxia is characterized by an increase in diastolic and mean blood flow velocity in the middle cerebral artery (MCA). The aim of this study was to assess whether MCA blood velocity in pregnancies with increased resistance to blood flow in the fete-placental circulation could predict the development of fetal asphyxia during labour. Fifty pregnant women with signs of increased fete-placental vascular resistance between 31 and 42 weeks of gestation were studied serially by Doppler ultrasound and the last examination was correlated to perinatal outcome. The MCA pulsatility index (PI), cerebroplacental PI ratio and mean MCA blood velocity were calculated and correlated to fetal outcome. Fetal brain-sparing was defined as MCA PI < mean - 2 S.D., cerebroplacental PI ratio <1.08 and mean MCA blood velocity >mean +2 S.D. No significant association was found between signs of fetal brain-sparing and the perinatal outcome. Among fetuses with signs of increased resistance to how in the umbilical artery, velocimetry of the middle cerebral artery did not identify those that would not withstand the strain of labour. (C) 1997 Elsevier Science Ireland Ltd.

引用

页码：177 / 184

页数：8

共 29 条

[1]

AKALINSEL T, 1994, OBSTET GYNECOL, V84, P439

[2] POSTTERM PREGNANCIES WITH NORMAL CARDIOTOCOGRAPHS AND AMNIOTIC-FLUID COLUMNS - THE ROLE OF DOPPLER EVALUATION IN PREDICTING PERINATAL OUTCOME [J].

ANTEBY, EY ;

TADMOR, O ;

REVEL, A ;

YAGEL, S .

EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 1994, 54 (02) :93-98

[3]

ARIAS F, 1995, AM J OBSTET GYNECOL, V172, P1943

[4] DISTRIBUTION OF CIRCULATION IN NORMAL AND ASPHYXIATED FETAL PRIMATE [J].

BEHRMAN, RE ;

LEES, MH ;

PETERSON, EN ;

DELANNOY, CW ;

SEEDS, AE .

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1970, 108 (06) :956-&

[5] CARDIOVASCULAR-RESPONSES TO HYPOXEMIA AND ACIDEMIA IN FETAL LAMBS [J].

COHN, HE ;

SACKS, EJ ;

HEYMANN, MA ;

RUDOLPH, AM .

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1974, 120 (06) :817-824

[6]

DEVINE PA, 1994, OBSTET GYNECOL, V84, P856

[7]

EDVINSSON L, 1993, CEREBRAL BLOOD FLOW, P40

[8]

Faber R, 1995, Zentralbl Gynakol, V117, P353

[9] QUANTITATIVE ANALYSIS OF OCCLUSIVE PERIPHERAL ARTERIAL DISEASE BY A NON-INTRUSIVE ULTRASONIC TECHNIQUE [J].

GOSLING, RG ;

DUNBAR, G ;

KING, DH ;

NEWMAN, DL ;

SIDE, CD ;

WOODCOCK, JP ;

FITZGERALD, DE ;

KEATES, JS ;

MACMILLAN, D .

ANGIOLOGY, 1971, 22 (01) :52-+

[10] CEREBRAL-UMBILICAL DOPPLER RATIO AS A PREDICTOR OF ADVERSE PERINATAL OUTCOME [J].

GRAMELLINI, D ;

FOLLI, MC ;

RABONI, S ;

VADORA, E ;

MERIALDI, A .

OBSTETRICS AND GYNECOLOGY, 1992, 79 (03) :416-420

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