1997 Fiscal Year Final Research Report Summary
EVALUATION OF FETAL WELL BEING DURING MATERNAL EXERCISE
| Project/Area Number |
07671830
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Obstetrics and gynecology
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| Research Institution | Nippon Medical School, Dep.Obstet.and Gynecol. |
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Principal Investigator |
ASAKURA Hirobumi (Dep.Obstet.and Gynecol.Nippon Medical School, assistant professor), 医学部, 助教授 (30167879)
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| Co-Investigator(Kenkyū-buntansha) |
KOSHINO Tatsuo (Dep.Obstet.and Gynecol.Nippon Medical School, assistant professor), 医学部, 教授 (80089747)
NAKAI Akihito (Dep.Obstet.and Gynecol.Nippon Medical School, assistant professor), 医学部, 助手 (20227721)
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| Project Period (FY) |
1995 – 1997
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| Keywords | MATERNAL EXERCISE / FETAL HEMODYNAMICS / VAST / ULTRASOUND |
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| Research Abstract |
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.
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[Publications] Nakai, A., Asakura, H., Mitake, H., Koshino, T., Araki, T.: "The effect of maternal exercise on ventricular output in the human fetus" Acta, Obstet.Gynecol.Japonica. (in press). (1998)
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