Doppler Ultrasound in Obstetrics and Gynecology
Doppler Ultrasound in Obstetrics and Gynecology
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多普勒超声在妇产科中的应用
DOI：
10.1007/978-3-031-06189-9_8
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Giussani D
中科院分区：
文献类型：
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作者：
Giussani D
在过去的50年里，随着合适动物模型的引入，我们对胎儿心血管生理学的理解显著增加。在研究出生前的心血管系统时，物种间心血管发育的时间概况是将其转化为人类临床情况的一个非常重要的考虑因素。大鼠和小鼠是晚熟物种，它们的心血管成熟持续到出生后，在出生后的第二周完成。此外，啮齿类动物生下幼崽，因此在高度多胎的物种中，母体对怀孕的代谢适应差异也需要明确的思考。相比之下，绵羊和人类有着相似的早产儿心血管发育的产前节奏，一些品种的绵羊产下的单胎羔羊体重与人类足月婴儿相似。最重要的是，绵羊是唯一一种允许对胎儿进行手术仪器以进行长期体内心血管记录的动物模型。在其他物种中还没有类似的基本见解。因此，本章总结了我们目前对胎儿心血管生理学的理解，主要来源于对胎儿羊在基础和应激条件下的研究，因此与人类产科直接相关。本文还综述了高龄妊娠、产前糖皮质激素治疗和不良宫内环境暴露对胎儿心血管功能的影响。
Our understanding of fetal cardiovascular physiology has markedly increased in the last 50 years, with the introduction of suitable animal models. When studying the cardiovascular system before birth, the temporal profile of cardiovascular development between species is a highly important consideration for translation to the human clinical situation. Rats and mice are altricial species, in which cardiovascular maturation continues past birth, becoming completed by the second week of postnatal life. In addition, rodents give birth to litters, so differences in the maternal metabolic adaptations to pregnancy in highly polytocous species also require clear thought. In contrast, sheep and humans share similar prenatal tempos of precocial cardiovascular development and some breeds of sheep give birth to singleton lambs of similar weight to term human babies. Most importantly, the sheep is the only animal model that permits surgical instrumentation of the fetus for long-term in vivo cardiovascular recording. Comparable fundamental insight has not been developed in another species. Therefore, this chapter summarizes our current understanding of fetal cardiovascular physiology derived primarily from studies in fetal sheep during basal and stressful conditions and thereby of direct human obstetric relevance. The effects on fetal cardiovascular function of advancing gestational age, antenatal glucocorticoid therapy, and exposure to adverse intrauterine conditions are also reviewed.