胎儿循环血流变化与胎儿生长受限关系的研究新进展

胎儿生长受限（FGR）是一种常见的妊娠合并症,其与临床不良事件、死产和胎儿脑性瘫痪的发生密切相关。目前,多普勒超声检查已被成功应用到胎儿血流动力学监测领域。但迄今为止,尚无统一的多普勒超声检查监测管理方案能有效降低FGR发病率和胎儿死亡率。FGR最常见的诱因是胎盘功能不全引发的氧气和营养物质缺乏。发生FGR时,胎儿各器官启动保护机制,血流动力学发生改变,这使得采用多普勒超声检查监测胎儿血流动力学变化来判断胎儿宫内状况成为可能。本文主要介绍了FGR的概念、胎儿血液循环系统及其与FGR的关系,以及部分多普勒血流动力学监测指标,包括脐动脉、大脑中动脉、子宫动脉、静脉导管和主动脉峡部的血流频谱指标以及心肌做功指数,并对其进行了综述,对比分析了各指标的优点和不足以及适用情况。

Research Progress on Relationship between Fetal Hemodynamics Changes and Fetal Growth Restriction

Fetal growth restriction（FGR） is a common type of pregnancy complication which is closely associated with adverse clinical outcomes,stillbirth,and cerebral palsy.Currently Doppler ultrasound has been successfully applied to the field of fetal hemodynamics monitoring.To date,however,there is no unified Doppler monitoring management program which can be used to effectively reduce cognitive morbidity and fetal mortality.The most common causes of FGR are hypoxia and malnutrition due to placental dysfunction.In the presence of FGR,the activation of protection mechanisms in fetal organs changes the fetal hemodynamics,which makes it possible to monitor intrauterine conditions through the monitoring of fetal hemodynamics changes using ultrasound Doppler.This review introduces the concept of FGR,fetal circulatory system physiology,the relationships between FGR and fetal circulatory system physiology,and some Doppler blood flow hemodynamics monitoring indicators,including the blood flow spectrum index of umbilical artery,middle cerebral artery,uterine artery,ductus venosus and aortic isthmus and myocardial performance index.And The advantages and disadvantages of each indicator and its application are compared and analyzed in this review.