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1.武汉市第八医院/武汉市肛肠医院妇产科,湖北 武汉 430010
2.武汉市江岸区妇幼保健院妇产科,湖北 武汉 430014
收稿:2025-12-13,
网络首发:2026-07-24,
纸质出版:2026-07-25
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马海英,叶晓娟.MRI评估孕晚期孕妇体位对胎盘血流及氧合的影响[J].局解手术学杂志,2026,35(07):610-613.
MA Hai-ying,YE Xiao-juan.MRI assessment of the effects of maternal postures on placental blood flow and oxygenation in the third trimester[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(07):610-613.
马海英,叶晓娟.MRI评估孕晚期孕妇体位对胎盘血流及氧合的影响[J].局解手术学杂志,2026,35(07):610-613. DOI: 10.11659/jjssx.12E025064.
MA Hai-ying,YE Xiao-juan.MRI assessment of the effects of maternal postures on placental blood flow and oxygenation in the third trimester[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(07):610-613. DOI: 10.11659/jjssx.12E025064.
目的
2
采用相位对比磁共振成像(PC-MRI)协同体素内不相干运动-多回波T2弛豫胎盘联合成像技术,探究孕晚期孕妇仰卧位、左侧卧位对胎盘血流及氧合功能的影响。
方法
2
选取2020年1月至2023年12月武汉市江岸区妇幼保健院收治的20例34~38周健康单胎孕晚期孕妇,先后完成仰卧位、左侧位MRI序列扫描,通过PC-MRI定量检测髂总动脉、脐静脉血流参数,依托体素内不相干运动-多回波T2弛豫胎盘联合成像技术测定胎盘灌注、胎儿区域伪扩散系数、血氧相关指标,对比两种体位下母胎循环相关参数差异。
结果
2
与左侧卧位相比,孕晚期采取仰卧位时,流入子宫的髂总动脉血流量减少23.7%(
P
<
0.001),胎盘输氧量减少6.2%(
P
=0.038),胎儿区域伪扩散系数降低26.2%(
P
=0.023);而两种体位下胎儿氧气输送量、胎儿血氧饱和度、脐静脉血流量比较,差异无统计学意义(
P
>
0.05)。
结论
2
PC-MRI协同体素内不相干运动-多回波T2弛豫胎盘联合成像技术可无创、精准评估孕晚期不同体位下胎盘血流与氧合变化,临床建议孕晚期孕妇优先采用左侧卧位,以降低胎盘灌注不足、胎儿亚临床缺氧风险。
Objective
2
To investigate the effects of supine and left-lateral postures of pregnant women on placental blood flow and oxygenation in the third trimester using phase-contrast magnetic resonance imaging(PC-MRI) combined with intravoxel incoherent motion-multi-echo T2 relaxation placental imaging.
Methods
2
Twenty healthy singleton pregnant women at 34 to 38 weeks of gestation in the third trimester who were admitted to Wuhan Jiang´an District Maternal and Child Health Hospital from January 2020 to December 2023 were enrolled. MRI scans were performed sequentially in the supine and left lateral postures. Blood flow parameters of the common iliac artery and umbilical vein were quantitatively measured using PC‑MRI.The placental perfusion, fetal pseudo‑diffusion coefficient, and blood oxygenation‑related parameters were determined by intravoxel incoherent motion-multi-echo T2 relaxation placental imaging. The differences in maternal‑fetal circulation parameters between the two postures were compared.
Results
2
Compared with the left lateral posture, the supine posture in the third trimester resulted in a 23.7% reduct
ion in common iliac artery blood flow to the uterus (
P
<
0.001), a 6.2% decrease in placental oxygen transfer (
P
=0.038), and a 26.2% reduction in the fetal pseudo‑diffusion coefficient (
P
=0.023). No statistically significant differences were observed between the two postures in fetal oxygen transfer, fetal oxygen saturation, or blood flow of umbilical vein (
P
>
0.05).
Conclusion
2
PC-MRI combined with intravoxel incoherent motion-multi-echo T2 relaxation placental imaging enables non‑invasive and precise evaluation of the changes of placental blood flow and oxygenation in different postures in the third trimester.In clinical practice, the left lateral posture is recommended as the preferred posture for pregnant women in the third trimester, so as to minimize the risk of impaired placental perfusion and subclinical fetal hypoxia.
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