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EVALUATION OF FETAL WELL BEING DURING MATERNAL EXERCISE

孕产妇运动期间胎儿健康状况的评估

基本信息

批准号：
07671830
负责人：
ASAKURA Hirobumi
金额：
$ 0.83万
依托单位：
Nippon Medical School, Dep.Obstet.and Gynecol.
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1997
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07671830/
关键词：
MATERNAL EXERCISE FETAL HEMODYNAMICS VAST ULTRASOUND 胎児胎児心機能循環動態超音波断層法 VAST

项目摘要

Fetal cardiovascular response were studied by ultrasonography during maternal exercise and vibrotory scoustic stimulation test (VAST) in 48 subjects from 36 to 41 weeks of gestation. The fetal heart rate (FHR), ventricular ejection time (ET), ventricular filling time (FT), ventricular stroke volume (SV) and cardiac output (CO) were measured by M-mode echocardiographic examination of the right and left ventricles, and the blood flow waveforms were obtained with color Doppler sonography from umbilical, external iliac and middle cerebral artery (UA, EA, MCA).In both groups, FHR increased by 110-113%, filling time (FT) decreased by 85% (p<0.05), and ejection time remained unchanged during 3rd trimester. Changes in FHR and FT of 2nd trimester were insignificant. In VAST group, SV decreased significantly dependent on decreasing FT, and CO remained unchanged after the stimulation. In exercise group, in spite of decreasing FT, the right and left SV Showed a moderate increase and CO showed a marked increase after the exercise. Positive relationship was seen between FHR and CO in exercise group. During 3rd trimester, the resistance index (RI) of the MCA after exercising had a positive correlation with CO and the RI of the EA after exercising had a negative correlation with CO.Increase in FHR in VAST group results in reduction of FT and end-diastolic volume, which in turn is accompanied by a decrease in SV as predicted by the Frank-Starling mechanism. In contrast, the findings in exercise group indicate that the major determinant of CO was FHR and not the FranK-Starling mechanism. Our findings for fetal blood flow velocimetry indicated that the maturation of fetal cardiovascular response during 3rd trimester, suggesting that the measuremants of these indices during maternal exercise are more valuable when determing potential threat to the fetus and in determining fetal safety limitation.

应用超声心动图和振动声刺激试验对48例妊娠36~41周孕妇的胎儿心血管反应进行了研究。用M型超声心动图测定胎心率(FHR)、左、右室射血时间(ET)、每搏量(SV)、心输出量(CO)，彩色多普勒超声测量脐动脉、髂外动脉、大脑中动脉(UA、EA、MCA)血流波形。两组妊娠3个月FHR增加110~113%，充盈时间(FT)减少85%(p&lt；0.05)，射血时间无明显变化。孕中期FHR和FT变化不明显。在VASH组，SV随FT的降低而显著降低，CO在刺激后无明显变化。运动组在FT降低的情况下，运动后左右心输出量呈中度增加，CO明显增加。运动组FHR与CO呈正相关。孕晚期，运动后大脑中动脉阻力指数(RI)与CO呈正相关，电针运动后RI与CO呈负相关，FHR增加导致FT和舒张末容量降低，进而伴随Frank-Starling机制预测的SV减小。相比之下，运动组的研究结果表明，CO的主要决定因素是胎心率，而不是Frank-Starling机制。我们的胎儿血流速度测定结果表明，胎儿心血管反应在妊娠晚期成熟，提示在母体运动中测定这些指标在确定对胎儿的潜在威胁和确定胎儿安全限度方面更有价值。