Clinical Significance of Ductus Venosus Waveform as Generated by Pressure- volume Changes in the Fetal Heart

Braga, Madalena; Moleiro, Maria Lúcia; Guedes-Martins, Luís

doi:10.2174/1573403x15666190115142303

Cited by 19 publications

(17 citation statements)

References 104 publications

(222 reference statements)

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“…The ductus venosus (DV) is a vascular shunt that acts as a pressure transducer and reflects pressure-volume changes in the fetal heart [34]. DV Doppler assessment is used to monitor the response to fetoscopic LASER surgery and in the early stratification of patients who are at risk of developing TTTS [35].…”

Section: Recipient Cardiovascular Pathophysiologymentioning

confidence: 99%

Fetal cardiovascular alterations in twin-to-twin transfusion syndrome

Rotar

Zaharie

Staicu

et al. 2020

Medicine and Pharmacy Reports

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Twin-to-twin transfusion syndrome (TTTS) is the consequence of vascular anastomoses of the shared placenta of monochorionic twin pregnancies. Both circulating inter-twin blood flow and vasoactive mediators imbalance cause hypovolemia in the donor and hypervolemia in the recipient fetus. If left untreated, TTTS has a high perinatal mortality rate and adverse long-term outcomes mainly cardiovascular and neurological. The recipient has cardiovascular changes including atrioventricular valve regurgitation, diastolic dysfunction and pulmonary stenosis/atresia. The maladaptive response to vascular changes determines a constant decreased blood flow in the donor that permanently modifies the arterial structure leading to postnatal alterations in the vascular system. Fetoscopic LASER surgery of placental vascular anastomoses may disrupt the underlying pathophysiology and improves cardiovascular function with normalization of systolic and diastolic function within weeks after treatment. The impact of cardiovascular changes is relevant for the safety of the management of a TTTS case. The improvement of the perinatal survival after intrauterine surgery leads to viable infants with the longer-term sequelae. Therefore accurate quantification of cardiovascular involvement is essential for clinicians for pregnancy management but also for patient counseling about the potential treatment options the outcome.

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Section: Recipient Cardiovascular Pathophysiologymentioning

confidence: 99%

Fetal cardiovascular alterations in twin-to-twin transfusion syndrome

Rotar

Zaharie

Staicu

et al. 2020

Medicine and Pharmacy Reports

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show abstract

“…While the umbilical cord itself spirals, the artery is accompanying the vein with spirals. The blood flow in the umbilical artery and vein, which ultrasound Doppler velocimetry is generally used to measure, shows different characteristics in pulsation: the artery has pulsation, but the vein, except the regions around the ductus venosus and portal vein, does not [2][3][4][5][6]. The difference in pulsation between the artery and vein has been also indicated by pressure [7].…”

Section: Introductionmentioning

confidence: 99%

“…The blood flow pattern could be influenced by the condition of fetal and placenta so that analyses of the flow pattern would be helpful for diagnosis. For example, the pulsation pattern of the blood flow in the artery and vein around the ductus venous and portal vein have been analyzed in pathological aspects [2][3][4][5][6]. In the meantime, the sizes of the umbilical cord, artery, and vein have been reported with some variation [8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Mechanical Environment in the Human Umbilical Cord and Its Contribution to the Fetal Circulation

Kato¹

2023

Maternal and Child Health

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The fetal blood flow in two arteries and one vein of the human umbilical cord could be influenced by the conditions of the fetal growth and placenta that the evaluation of the blood flow pattern by ultrasound Doppler velocimetry is important. That is, the mechanical environment in the umbilical cord should be kept to maintain the blood flow suitable for good fetus growth. In this chapter, a human umbilical cord model for finite analysis, based on the mechanical and histological characteristics is proposed. Considering that the active force production by hyaluronan, proteoglycan, smooth muscle cells, and myofibroblasts could influence the mechanical environment in the umbilical cord, the computation with the proposed model was carried out in order to evaluate the influence. The changes in the mechanical environment caused by the active force production and their influences on the fetal blood flow through the pressure rise and drop in the arteries of the umbilical cord are introduced.

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“…The fetal hepatic venous system (HVS) is a special part of the fetal cardiovascular system, which consists of an intra-abdominal segment of umbilical vein (UV), intra-and extrahepatic portal veins (PVs), ductus venous (DV), hepatic veins (HVs) and a portion of inferior vena cava (IVC) [1,2]. The highly oxygenated blood from the placenta is redistributed in fetal HVS before it flows into fetal heart, which is considerably vital to the normal development and growth of fetus [3,4].…”

Section: Introductionmentioning

confidence: 99%

A large-scale investigation by ultrasound of fetal hepatic venous system variants in China

et al. 2022

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Aim: To investigate the types, associated anomalies and postnatal outcomes of fetal hepatic venous system (HVS) variants by ultrasound in China.Material and methods: A large-scale and prospective investigation of HVS variants for low-risk singleton pregnant women was performed in three academic tertiary referral care centers in China. Ultrasound imaging wasused for the identification and follow-up of anatomical variants. Follow-up was conducted once every four weeks prenatally and every two months postnatally, mainly concerned on the adverse events that may appear.Results: There were 20848 cases with anatomical variants of fetal HVS identified from 46179 candidates during the study period. Following the anatomical position of variants occurring, four main divisions were present: main portal vein variants (17.9%), intrahepatic portal vein variants (21.30%), intrahepatic persistent right umbilical vein (0.27%) and hepatic vein variants (5.67%). In the fetal period, the pregnancy of all cases was normally continued, except that the pregnancy of two cases, which were associated with multiple anomalies and were terminated by their parents. After birth, approximately 99.47% of the cases with isolated variants orbeing associated no clinic significant anomalies were normally alive. Approximately 0.50% cases were associated with simple ventricular septum defect or tetralogy of Fallot and further treatment was needed.Conclusion: The anatomical variants of fetal HVS may appear as numerical, morphological or positional variants of MPV, intrahepatic PV branches, intrahepatic PRUV and HVs. The majority of cases are isolated or their associated anomalies are not clinically significant and have normal lifeafter birth.

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Clinical Significance of Ductus Venosus Waveform as Generated by Pressure- volume Changes in the Fetal Heart

Cited by 19 publications

References 104 publications

Fetal cardiovascular alterations in twin-to-twin transfusion syndrome

Fetal cardiovascular alterations in twin-to-twin transfusion syndrome

Mechanical Environment in the Human Umbilical Cord and Its Contribution to the Fetal Circulation

A large-scale investigation by ultrasound of fetal hepatic venous system variants in China

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