Differentiation between human fetal breathing patterns by investigation ofbreathing-related tracheal fluid flow velocity using Doppler sonography

Citation
Kd. Kalache et al., Differentiation between human fetal breathing patterns by investigation ofbreathing-related tracheal fluid flow velocity using Doppler sonography, PRENAT DIAG, 20(1), 2000, pp. 45-50
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Reproductive Medicine","Medical Research Diagnosis & Treatment
Journal title
PRENATAL DIAGNOSIS
ISSN journal
0197-3851 → ACNP
Volume
20
Issue
1
Year of publication
2000
Pages
45 - 50
Database
ISI
SICI code
0197-3851(200001)20:1<45:DBHFBP>2.0.ZU;2-T
Abstract
We report our results from the analysis of Doppler measurements of breathin g-related fluid flow velocity waveforms in the trachea in human fetuses. Ou r aim was to determine whether, using the proposed method, reproducible pat terns can be recognized over the latter half of gestation. Breathing-relate d tracheal fluid flow velocity of 47 normal fetuses at 20-39 weeks' gestati on were analysed. Colour Doppler was used to document 'streaming' of fluid in the trachea, followed by spectral Doppler to record flow velocity wavefo rms. More than 40 (median 94 range 42-725) continuous breathing cycles (ins piration + expiration) were obtained in each case. Although breathing-relat ed fetal tracheal fluid flow waveforms were found to be highly variable, we were able to distinguish by visual analysis between a regular and an irreg ular pattern. Among the regular patterns, we further differentiate between a regular symmetric (sinusoidal type) and a regular asymmetric (deep inspir ation with expiratory flow retardation) pattern. The regular pattern occurr ed consistently in all age groups studied and there were no significant (p< 0.05) differences in the occurrence rate of the regular symmetric and asymm etric pattern. The incidence of the regular pattern increased significantly (p<0.05) from 11.74 +/- 3.38% (mean +/- SEM) at 24-27 weeks to 20.72 +/- 1 .75% at 28-31 weeks of gestation and remained constant thereafter. This stu dy shows that the proposed method can provide detailed information on breat hing-related tracheal fluid flow velocity as early as 20 weeks of gestation . The information that a regular symmetric pattern was observed throughout the second half of gestation is important. Hence, a higher standardization of on-going fetal breathing movements studies may be achieved by measuring breathing-related tracheal fluid flow velocity waveform parameters only dur ing this pattern. Copyright (C) 2000 John Wiley & Sons, Ltd.