目的:我们分析的主题是胎儿颈部脐带碰撞对胎儿心功能和脑循环的影响。
方法:我们的研究对象是115个单胎妊娠胎儿,在怀孕的第15到40周。在我们的分析中,我们检查了以下参数:右心室的Tei指数,具有Tei指数成分的左心室的Tei指数:等容收缩时间,等体积弛豫时间,射血时间和心胸面积比,大脑中动脉收缩期峰值血流速度(PSMCA),大脑中动脉搏动指数(PIMCA)。在我们的研究中,妊娠年龄为:28±2±34。研究组胎儿脐带绕颈组(fUCAN)包括38例胎儿(男20例,18名女性)。对照组无胎儿脐带绕颈组(NfUCAN)的胎儿77例(男43例,34名女性)。
结果:在我们的研究中,我们发现获得的值没有显着差异:fUCAN中的TeiLV:0.5±0.1vs.在NfUCAN中:0.5±0.1;p=0.42),TeiRVinfUCAN:0.5±0.2vs.在NfUCAN中:0.4±0.1;(p=0.2)。观察到三尖瓣反流-TR的频率如下:fUCAN:7/38,18%vs.NfUCAN:13/77,17%;p=0.8。研究fUCAN组的MCAPS显着高于NfUCAN(40.2±11.5vs.32.5±9.5;p=0.003),尽管其他血液动力学和临床变量在研究组和对照组之间没有差异.
结论:胎儿脐带颈碰撞不影响以Tei指数表示的胎儿心功能,在胎儿心脏检查时(平均胎龄29+4周)。fUCAN小组提出了提高的PSMCA,这与研究组和对照组之间的其他血液动力学和临床变量无关。
OBJECTIVE: The subject of our analysis is the influence of umbilical cord collision around the fetal neck on the fetal heart function and cerebral circulation.
METHODS: Our study was carried out on a group of 115 fetuses from single pregnancies with physiological course, during the 15th to 40th week of pregnancy. In our analysis, we examined the following parameters: Tei index for right ventricle, Tei index for left ventricle with Tei index components: isovolumetric contraction time, isovolumetric relaxation time, ejection time and cardiothoracic area ratio, middle cerebral artery peak systolic velocity (PS MCA), middle cerebral artery pulsatility index (PI MCA). Gestational age in our study was: 28+2±34. The study group of patients with fetal umbilical cord around neck group (fUCAN) included 38 fetuses (20 males, 18 females). The control group of patients with no fetal umbilical cord around neck group (NfUCAN) included 77 fetuses (43 males, 34 females).
RESULTS: In our study, we found no significant differences in the values obtained: Tei LV in fUCAN: 0.5±0.1 vs. in NfUCAN: 0.5±0.1; p=0.42), Tei RV in fUCAN: 0.5±0.2 vs. in NfUCAN: 0.4±0.1; (p=0.2). Tricuspid valve regurgitation-TR was observed with the following frequency: fUCAN: 7/38, 18% vs. NfUCAN: 13/77, 17%; p=0.8. MCA PS in study fUCAN group was significantly higher than in NfUCAN (40.2±11.5 vs. 32.5±9.5; p=0.003), although other hemodynamic and clinical variables did not differ between the study and control groups.
CONCLUSIONS: The fetal nuchal umbilical cord collision did not affect the fetal heart function expressed as Tei index, at the time of fetal heart examination (at mean gestational age 29+4 weeks). The fUCAN group presented elevated PS MCA, which was not related to other hemodynamic and clinical variables between the study and control groups.