Izvorni znanstveni članak
THE CORRELATION OF UTERINE MUSCLE ELECTROMYOGRAPHIC (EMG) ACTIVITY AND FETOPLACENTAL, FETAL AND UTERINE ARTERIAL BLOOD FLOW
Snježana Škrablin
Ivan Kuvačić
Vladimir Banović
Sažetak
Negative factors can influence the development of the placenta during the midterm of the second trimester having negative effects on the fetal growth and development. The aim of this study was to determine possible negative influences of pathologic electromyographic uterine activity (EMG activity) during the second trimester on the process of placental development, the effects of pathologic EMG activity on the fetoplacental, fetal and uterine blood flow, fetal birthweight and the changes depending on the success or failure of ritordine therapy. Methods. 114 pregnant women were divided in four groups (A, B, C, D) according to the electromyographic findings after the 20th week of pregnancy and the ritordine treatment. Group A were pregnancies (N=41) with ellectrically quiet myometrium, group B (N=17) pregnancies with pathologic EMG activity unopposed by the therapy, group C (N=34) were pregnancies with persistent pathologic EMG activity in spite of the therapy, while group D (N=22) were pregnancies with electrically quiet myometrium during the ritodine therapy. Fetal aortal and fetal middle cerebral artery, umbilical and arcuate artery resistance indexes (RI) and blood flow velocities, were measured from the 28th week of pregnancy until the delivery. Results. Pregnant women with pathologic uterine EMG activity before the 24th week who received no treatment (B) had significantly higher values of resistance indexes in the arcuate and umbilical arteries compared to pregnant women without uterine electrical activity (group A), pregnant women who were successfully treated (group D) and those with EMG uterine activity during the ritordine therapy (group C). In total, 70% of children born in group B were growth retarded, compared to 7% in group A and 9% in group D. Resistance indexes in the fetal aorta in group B were significantly higher than in the groups A, C, and D. Group B had a significantly lower systolic, diastolic and middle blood flow velocity in aorta and umbilical artery than in the other groups, with significant velocity increment in the middle cerebral artery, compared to the group A. Conclusion.¬ Pathologic uterine EMG activity predicts placental hemodynamic disorder, which, by causing abnormal placentation, leads to consequential abnormalities in fetal and fetoplacental blood flow and growth retardation. Tocolitic ritordine therapy¬ is just one possibility for stopping pathological EMG uterine activity but still, it is far from perfect. It appears, however, that blood flow divergences during the therapy are not the consequences of the pharmacologic effect of the drug itself, but of the drugs tocolytic success or failure.
Ključne riječi
electrical uterine activity; fetal and uterine blood flow; electromyography; preterm labor
Hrčak ID:
15531
URI
Datum izdavanja:
1.9.2003.
Posjeta: 3.479 *