Changes in venous flow and intra tracheal flow in fetal breathing movements

Chiba, Yoshihide; Utsu, Masaji; Kanzaki, Toru; Hasegawa, T.

doi:10.1016/0301-5629(85)90006-7

Cited by 49 publications

(21 citation statements)

References 15 publications

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“…Blood flow in the fetal vena cava shows a pulsatile pattern, synchronized with the car diac cycle in an animal model [1] and in human fetuses studied using pulsed Doppler ultrasound [2], In fetal arrhythmias, inferior vena cava (IVC) blood flow shows a charac teristic pattern corresponding to each type of arrhythmia, i.e., the velocity of the reverse flow which coincides with premature atrial contraction becomes higher due to the in crease in intra-atrial pressure [3]. In the pres ence of specific arrhythmias or growth fail ure, fetal morbidity appears to be associated PA = Pulmonary atresia; EFE = endocardial fi broelastosis; TR = tricuspid regurgitation; GW = ges tational age in weeks.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Preload Condition of the Fetus by Inferior Vena Caval Blood Flow Pattern

Kanzaki

Chiba²

1990

Fetal Diagn Ther

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108

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Using pulsed Doppler ultrasound, blood flow in the inferior vena cava (IVC) was studied in 47 normal fetuses from 24 to 40 weeks of gestation and 35 abnormal fetuses, with the exception of those with arrhythmias. The abnormal fetuses were divided into 4 groups according to diagnosis, i.e., 6 cases of heart disease with hydrops (group 1), 9 cases of heart disease without hydrops (group 2), 11 cases of hydrops without heart disease (group 3), and 9 cases of other fetal diseases (group 4). By measuring the velocity of IVC blood flow, we defined a new index, the change in parallel with reverse flow velocity, and called it the preload index (PLI). In normal fetuses, PLI values ranged from 0 to 0.37 and had no relation with gestational age. The PLI was significantly higher in groups 1–3 than in normal fetuses. In group 1, the PLI was also higher than in group 2. In group 3, the PLI values in 4 cases of chylothorax, 1 of chyloascites and 1 of cytomegalovirus infection were significantly lower than in the remaining 5 cases where the cause of hydrops was undetermined. The PLI was normal in 9 fetuses with other diseases and no hydrops. The PLI was increased in conditions in which excessive preload, tricuspid regurgitation, or some kind of structural heart disease were present.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the Preload Condition of the Fetus by Inferior Vena Caval Blood Flow Pattern

Kanzaki

Chiba²

1990

Fetal Diagn Ther

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108

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“…In this study, breathing-related tracheal¯uid¯ow velocity was recorded during an extended sampling period in healthy human fetuses in the second half of pregnancy. Although similar Doppler analyses have been reported in the literature, they were based on a small population group and performed over a very short observation time (Chiba et al, 1985;Isaacson et al, 1991). In addition, it has been common practice to record the Doppler curves using a fast sweep speed so that simultaneous assessment of a maximum of only three or four breathing cycles was possible.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, major interest has focused on the observation of this phenomenon in human fetuses. The improved diagnostic potential of ultrasound equipment has made possible the assessment of breathing-related fetal nasal (Badalian et al, , 1996 and tracheal (Chiba et al, 1985;Isaacson et al, 1991;Kalache et al, 1997)¯uid¯ow velocity. Preliminary studies have demonstrated that in fetuses with congenital diaphragmatic hernia, the upper respiratory tract function as assessed by the Doppler technique seems to correlate with the severity of lung hypoplasia Badalian et al, 1994;Fox et al, 1997;Kalache et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

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

Kalache¹,

Chaoui²,

Marcks³

et al. 2000

Prenat. Diagn.

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We report our results from the analysis of Doppler measurements of breathing-related fluid flow velocity waveforms in the trachea in human fetuses. Our aim was to determine whether, using the proposed method, reproducible patterns can be recognized over the latter half of gestation. Breathing-related tracheal fluid flow velocity of 47 normal fetuses at 20-39 weeks' gestation were analysed. Colour Doppler was used to document 'streaming' of fluid in the trachea, followed by spectral Doppler to record flow velocity waveforms. More than 40 (median 94; range 42-725) continuous breathing cycles (inspiration+expiration) were obtained in each case. Although breathing-related fetal tracheal fluid flow waveforms were found to be highly variable, we were able to distinguish by visual analysis between a regular and an irregular pattern. Among the regular patterns, we further differentiate between a regular symmetric (sinusoidal type) and a regular asymmetric (deep inspiration with expiratory flow retardation) pattern. The regular pattern occurred consistently in all age groups studied and there were no significant (p<0.05) differences in the occurrence rate of the regular symmetric and asymmetric 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 study shows that the proposed method can provide detailed information on breathing-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 during this pattern.

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“…This observation is of major importance as it may be of use when Doppler measurements of tracheal fluid flow during fetal breathing movements are considered in human fetuses. By knowing the tracheal diameter, the volume of intratracheal liquid moved per breath has been estimated [5,7]. Moreover, it has been shown that, in fetuses with congenital diaphragmatic hernia, the volume per breath correlates directly with the severity of lung hypoplasia [8].…”

Section: Discussionmentioning

confidence: 99%

“…However, the invasive character of these studies has considerably limited the extrapolation of results to human pregnancies. Conversely, in human fetuses, high-resolution ultrasonography has made it possible to visualise the upper airways [1], to measure the inner tracheal diameter [2][3][4] and to assess intratracheal lung fluid dynamics using Doppler ultrasonography during fetal breathing movements [5][6][7]. The latter is clinically important, as a reduced intratracheal volume movement per breath is associated with lethal pulmonary hypoplasia [8].…”

Section: Introductionmentioning

confidence: 99%

Visualisation and Measurement of Tracheal Diameter in the Sheep Fetus: An Ultrasound Study with Stereomicroscopic Correlation

Kalache¹,

Nishina²,

Ojutiku³

et al. 2001

Fetal Diagn Ther

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Objective: There is no information on ultrasonographic visualisation of the upper airways in the sheep fetus, but this species permits to examine the accuracy of ultrasonography in measuring the inner tracheal diameter. This was the aim of our study. Methods: Transabdominal ultrasonography to visualise the trachea was attempted in 16 unsedated Welsh Mountain ewes with a singleton pregnancy at 70 (SD 2) days gestation (term 148 days). The ultrasonographically measured inner tracheal diameter was compared with the actual inner tracheal diameter obtained by stereomicroscopy post-mortem. Results: High-resolution ultrasonography permitted clear imaging of the fetal trachea in 87% (14/16) of the cases analysed. The ultrasound measurements were smaller than the corresponding stereomicroscopic measurements, the mean ± SD difference between the measurements being 0.40 ± 0.12 mm. Conclusions: Improvements in ultrasound have led to increased interest in the assessment of the trachea in human fetuses. Our study in the ovine fetus at mid gestation shows that optimal views of the fetal trachea allowing accurate measurements can be obtained in almost all the cases.

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Changes in venous flow and intra tracheal flow in fetal breathing movements

Cited by 49 publications

References 15 publications

Evaluation of the Preload Condition of the Fetus by Inferior Vena Caval Blood Flow Pattern

Evaluation of the Preload Condition of the Fetus by Inferior Vena Caval Blood Flow Pattern

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

Visualisation and Measurement of Tracheal Diameter in the Sheep Fetus: An Ultrasound Study with Stereomicroscopic Correlation

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