FETAL CARDIAC-FUNCTION IN INTRAUTERINE GROWTH-RETARDATION

被引:152
作者
RIZZO, G [1 ]
ARDUINI, D [1 ]
机构
[1] UNIV CATTOLICA SACRO CUORE, DEPT OBSTET & GYNECOL, FETAL PHYSIOL LAB, I-00168 ROME, ITALY
关键词
INTRAUTERINE GROWTH RETARDATION; DOPPLER ULTRASONOGRAPHY; FETAL HEART; ECHOCARDIOGRAPHY;
D O I
10.1016/0002-9378(91)90431-P
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Blood-flow velocity waveforms are altered in several peripheral vascular beds of fetuses whose intrauterine growth is retarded because of placental insufficiency. We investigated these concomitant changes in cardiac function. Color and pulsed Doppler echocardiographic recordings were performed in 124 fetuses with intrauterine growth retardation. These fetuses were free of structural and chromosomal abnormalities and were characterized by increased umbilical artery resistance and reduced middle cerebral artery resistance. Twenty-four of these fetuses were also studied at weekly intervals until the onset of antepartum late heart rate decelerations. Blood-flow velocity waveforms were obtained from the aortic and pulmonary valves, and the following variables were measured: peak systolic velocity, time to peak velocity, the product of time velocity integral multiplied by heart rate, left and right cardiac output, and the right/left ratios of the product of time velocity integrals multiplied by heart rate and cardiac output. When compared with previously established norms, both aortic and pulmonary peak systolic velocities and pulmonary time to peak velocity were reduced; aortic time to peak velocity increased. Left cardiac output and the product of the aortic time velocity integral multiplied by the heart rate increased and right cardiac output and the product of the pulmonary time velocity integral multiplied by the heart rate decreased, resulting in reduced right/left ratios. In the 24 fetuses studied longitudinally, time to peak velocities and the right/left flow ratios remained stable. However, aortic and pulmonary peak velocities and cardiac output declined significantly in contrast to an expected rise with advancing gestation. The fall in cardiac output and aortic and pulmonary peak velocities was directly related to umbilical artery pH at birth. This study provides evidence of a modified cardiac function that seems to deteriorate progressively with the advancing gestation of fetuses with intrauterine growth retardation.
引用
收藏
页码:876 / 882
页数:7
相关论文
共 23 条
  • [1] ADUINI D, 1988, FETAL THER, V3, P31
  • [2] EVIDENCE OF REDISTRIBUTION OF CARDIAC-OUTPUT IN ASYMMETRICAL GROWTH-RETARDATION
    ALGHAZALI, W
    CHITA, SK
    CHAPMAN, MG
    ALLAN, LD
    [J]. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1989, 96 (06): : 697 - 704
  • [3] ARDUINI D, 1991, OBSTET GYNECOL, V77, P370
  • [4] NORMAL VALUES OF PULSATILITY INDEX FROM FETAL VESSELS - A CROSS-SECTIONAL STUDY ON 1556 HEALTHY FETUSES
    ARDUINI, D
    RIZZO, G
    [J]. JOURNAL OF PERINATAL MEDICINE, 1990, 18 (03) : 165 - 172
  • [5] Creasy R. K., 1973, Foetal and neonatal physiology., P398
  • [6] FETAL CARDIAC-OUTPUT ESTIMATED BY DOPPLER ECHOCARDIOGRAPHY DURING MIDGESTATION AND LATE GESTATION
    DESMEDT, MCH
    VISSER, GHA
    MEIJBOOM, EJ
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1987, 60 (04) : 338 - 342
  • [7] UMBILICAL ARTERY VELOCITY WAVEFORMS AND INTRAUTERINE GROWTH-RETARDATION
    FLEISCHER, A
    SCHULMAN, H
    FARMAKIDES, G
    BRACERO, L
    BLATTNER, P
    RANDOLPH, G
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1985, 151 (04) : 502 - 505
  • [8] FETAL CARDIAC AND PERIPHERAL ARTERIAL FLOW VELOCITY WAVEFORMS IN INTRAUTERINE GROWTH-RETARDATION
    GROENENBERG, IAL
    WLADIMIROFF, JW
    HOP, WCJ
    [J]. CIRCULATION, 1989, 80 (06) : 1711 - 1717
  • [9] INCREASED VASCULAR-RESISTANCE IN THE DESCENDING AORTA OF THE HUMAN-FETUS IN HYPOXIA
    JOUPPILA, P
    KIRKINEN, P
    [J]. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1984, 91 (09): : 853 - 856
  • [10] CHANGES IN INTRACARDIAC BLOOD-FLOW VELOCITIES AND RIGHT AND LEFT-VENTRICULAR STROKE VOLUMES WITH GESTATIONAL-AGE IN THE NORMAL HUMAN-FETUS - A PROSPECTIVE DOPPLER ECHOCARDIOGRAPHIC STUDY
    KENNY, JF
    PLAPPERT, T
    DOUBILET, P
    SALTZMAN, DH
    CARTIER, M
    ZOLLARS, L
    LEATHERMAN, GF
    SUTTON, MGS
    [J]. CIRCULATION, 1986, 74 (06) : 1208 - 1216