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目的研究妊娠高血压综合征(妊高征)对胎儿心功能的影响。方法选择2007年1~6月在复旦大学附属妇产科医院和上海国际和平妇幼保健院建卡就诊的妊高征孕妇和正常血压孕妇为研究对象。妊高征孕妇根据高血压严重程度分为A组(妊娠期高血压或轻度子前期)和B组(重度子前期);正常血压孕妇为对照组。孕期进行胎儿超声心动图检查,测量并比较各组间心脏收缩、舒张和心脏整体功能各项指标。结果A组16例,B组15例,对照组36例进入分析。3组孕妇的平均年龄为B组>A组>对照组,3组胎儿的出生孕周和体重均为B组A组>对照组,但差异总体上无统计学意义(P分别为0.071和0.092);左室缩短分数和射血分数为B组A组>对照组,但差异总体上无统计学意义(P=0.275);右室Tei指数为B组>A组>对照组,总体上差异无统计学意义(P=0.068),而B组右室Tei指数显著高于对照组(P=0.023)。结论妊高征可导致胎儿的左心血量增加、收缩功能受损,左室顺应性下降;重度子前期孕妇的胎儿可出现右室整体功能受损。
Objective To study the effect of pregnancy-induced hypertension (PIH) on fetal cardiac function. Methods From January to June 2007, pregnant women with PIH and pregnant women with normotensive were selected as the study objects in Cardiovascular Institute of Obstetrics and Gynecology Hospital of Fudan University and Shanghai International Peace Maternal and Child Health Hospital. Pregnancy-induced hypertension according to the severity of hypertension were divided into group A (gestational hypertension or mild pre-eclampsia) and B (severe pre-eclampsia); normotensive pregnant women as the control group. Fetal echocardiography during pregnancy, measurement and comparison of various groups systolic, diastolic and cardiac function of the various indicators. Results 16 cases in group A, 15 cases in group B and 36 cases in control group were analyzed. The mean age at 3 groups of pregnant women was group B> group A> control group. The gestational weeks and body weights of 3 groups of fetuses were group B A group> control group, but the difference was not statistically significant (P = 0.071 and 0.092 respectively); the shortening of left ventricular fraction and ejection fraction were in group B group A> control group, but the difference was not statistically significant (P = 0.275); Tei index of right ventricle was group B> group A> control group, but the difference was not statistically significant (P = 0.068), while the Tei index of right ventricle of group B was significantly higher than that of control group (P = 0.023). Conclusions Pregnancy-induced hypertension can lead to increased left ventricular blood volume, impaired systolic function and decreased left ventricular compliance. Preimplantation fetus may have impaired right ventricular function.