EFFECTS OF MATERNAL POSTURAL CHANGE FROM SUPINE TO LEFT-LATERAL ON TOCOLYSIS, MATERNAL CARDIAC FUNCTION AND PULSATILITY INDEX OF UTERINE ARTERY
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概要
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切迫早産管理のあり方として, まず安静療法がとられ, とくにcaval compressionを避ける目的にて左側臥位が勧められている. そこで安静療法としての仰臥位と左側臥位での子宮収縮抑制効果 (頻度, resting uterine tonus) を対比評価してみた. また母体循環動態としての心拍出量 cardiac output (CO)をImpedance cardiographyにより, また子宮動脈血管抵抗指数 (PI) をPulsed Doppler法にて測定し, tocolysisとの関連性を明らかにせんとした. 仰臥位より左側臥位への母体体位変換にて, (1) 子宮収縮頻度 (切迫早産92例, 分娩101例) の減少がみられ (p<0.01), とくに切迫早産例で顕著にみられた. (2) resting uterine tonus (n=5)も左側臥位にて低下した (p<0.05). (3) 子宮収縮と母体循環動態との関連において, 子宮収縮頻度の減少とともにCOは増大し(p<0.01), またPIの低下 (p<0.01) が認められた. 以上のことより, 仰臥位より左側臥位への体位変換は, 子宮収縮頻度と resting uterine tonusを低下させたが, その背景として, 妊娠子宮による仰臥位での aorto-caval compressionを緩和させ, 母体心拍出量の増加をもたらせ同時に子宮動脈血管抵抗を低下させる. そして, また resting uterine tonusが低下するが, これは前述のごとき静脈還流の改善に基づく紘毛間腔圧の低下に起因する. こうした減少が相まつて子宮筋乏血を改善させて子宮収縮頻度の抑制につながるものと考察した.
- 社団法人日本産科婦人科学会の論文
- 1991-06-01
著者
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HIDAKA Atsuo
Department of Obstetrics and Gynecology Osaka City University Medical School
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Park Yong
Department Of Applied Biological Chemistry Faculty Of Agriculture Shizuoka University
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Hidaka Atsuo
Department Of Obstetrics And Gynecology Osaka City University School Of Medicine
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Park Yong
Department Of Obstetrics And Gynecology Osaka City University School Of Medicine
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Park Yong
Department of Advanced Materials, Engineering for Information and Electronics, Kyung Hee University, Yongin 446-701, Korea
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Park Yong
Department of Advanced Materials Engineering, Kyonggi University, Suwon, Gyeonggi-do 443-760, Republic of Korea
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