妊娠前半期胎儿脐血流循环特点的分析.pdf

妊娠前半期胎儿脐血流循环特点的分析 论文类别：医药学 - 医学 上传时间：2012/9/10 11:49:00 论文作者：未知 作者：于月成，辛晓燕，王西林，黄侃，韩增辉， 于铭， 陈定章 【关键词】妊娠 【Abstract】AIM: To investigate the development of fetal umbilical blood flow in the normal first and early second trimesters. METHODS: Umbilical artery and vein blood flow of 132 normal fetuses were analyzed with pulsed wave Doppler at 8 to 20 week gestations. P/M and umbilical artery flow diastolic expression (UADE) were observed. RESULTS: The spectra of umbilical venous flow was three or two phases before 10 week gestations and they all became two phases at 11 to 12 week gestations. With the pregnancy progress， the fluctuation of umbilical blood flow disappeared gradually. After 16 week gestations， spectra of all fetal umbilical vein blood flow showed stable conditions. From 8 to 16 week gestations， the maximal velocity of fetal umbilical vein blood flow increased twice and the beat index descended from 1.63±0.04 to 1.12±0.02 (P0.01). The beat index was related to the pregnant weeks. CONCLUSION: The development fetal umbilical vein has an obvious phase characteristics. The stable spectra of umbilical venous flow after 16 week gestations suggests that the oxygenated blood into the fetus through umbilical vein is stable， which can be used to assess the fetal condition. 【Keywords】pregnancy; fetus; umbilical veins; umbilical arteries; ultrasonography，doppler，color 【摘要】目的: 探讨正常妊娠前半期脐血流循环发展的特点.方法: 对妊 娠8～20 wk 的132 例正常胎儿的脐动、静脉血流进行多普勒频谱分析.观察指 标:脐静脉血流频谱及波动比，脐动脉血流舒张成分. 结果: 妊娠10 wk 前脐静 脉血流频谱为三相或两相；妊娠11～12 wk 脐静脉血流频谱均为两相. 随着妊 娠继续，脐静脉血流波动消失，妊娠16 wk 以后所有胎儿的脐静脉血流频谱呈 现稳定状态. 妊娠从8～2 wk 胎儿脐静脉血流时间平均速度增加一倍，脐静脉 血流波动比从163±004 降低到112±002. 波动比与妊娠时间明显差异 （P0.01）.脐动脉血流舒张成分出现于妊娠13 wk，妊娠15 wk 以后 脐动脉 血流均出现舒张成分. 结论： 脐血流循环形成具有明显的阶段特征，妊娠16 wk 以后稳定的脐静脉血流是自胎盘经脐静脉进入胎儿的氧合血供给稳定的反映， 可以成为妊娠前半期对胎儿综合状况评价的诊断依据. 【关键词】妊娠； 胎儿； 脐静脉； 脐动脉； 超声检查，多普勒，彩色 0 引言 脐带是连接母体和胎儿的扭带，对胎儿生长发育至关重要.脐带中有一条静 脉及两条动脉.