Longitudinal study of umbilical and portal venous blood flow to the fetal liver: Low pregnancy weight gain is associated with preferential supply to the fetal left liver lobe
Longitudinal study of umbilical and portal venous blood flow to the fetal liver: Low pregnancy weight gain is associated with preferential supply to the fetal left liver lobe
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DOI：
10.1203/pdr.0b013e318163a1de
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发表时间：
2008-03-01
影响因子：
3.6
通讯作者：
Kiserud, Torvid
中科院分区：
文献类型：
--
作者：
Kessler, Jorg;Rasmussen, Svein;Kiserud, Torvid
最近的数据表明，胎儿肝脏的脐静脉灌注对胎儿的生长和出生后的肝功能有重要的影响，并在妊娠后期的母体因素修改这种循环。在一项对160例低风险妊娠的纵向研究中，我们确定了胎儿肝脏的脐静脉和门静脉血流在妊娠期间的变化，并检查了母体体重指数和妊娠体重增加影响胎儿肝脏血流的假设。我们用超声波测量脐静脉、门静脉、门静脉左分支和静脉导管的血流量。将估计的胎儿体重标准化，在妊娠21-39周期间，胎儿肝脏总静脉血流量从84 mL.min（-1）.kg（-1）降至57 mL.min（-1）.kg（-1）;到足月，门静脉血流量增加（从14%降至20%），脐静脉血流量下降，而左右肝叶之间的分布稳定，为60%/40%。营养丰富的脐静脉血流向肝脏的流量较大与出生体重和新生儿体重指数较高有关。母体体重指数与胎儿肝血流量无关，但低妊娠体重增加强烈影响左右肝叶之间的血流分布，保留左叶，并增加16%的叶之间的差异。
Recent data suggest that umbilical venous perfusion of the fetal liver has an important influence on fetal growth and postnatal liver function, and that maternal factors in late pregnancy modify this circulation. In a longitudinal study of 160 low-risk pregnancies, we determined how umbilical and portal venous blood flows to the fetal liver changed during gestation, and examined the hypothesis that maternal body mass index and pregnancy weight gain influenced fetal liver blood flows. We measured blood flows in the umbilical and portal veins, left portal branch, and ductus venosus using ultrasound. Normalizing for estimated fetal weight, fetal liver total venous blood flow fell from 84 to 57 mL.min(-1).kg(-1) during 21-39 wk of gestation; toward term the portal contribution increased (from 14 to 20%) and the umbilical contribution fell, whereas distribution between the left and right liver lobes was stable, 60%/40%. Greater flow of nutrient-rich umbilical venous blood to the liver was associated with higher birth weight and neonatal ponderal index. Maternal body mass index was not related to fetal liver blood flows, but low pregnancy weight gain strongly influenced flow distribution between the right and left liver lobes, sparing the left lobe and increasing the difference between lobes by 16%.