Development of quantitative Doppler indices for uteroplacental and fetal blood flow during the third trimester

Joern, H.; Funk, A; Goetz, Martin; Kuehlwein, Holger; Klein, Alfred; Fendel, H.

doi:10.1016/0301-5629(96)00090-7

Cited by 27 publications

(18 citation statements)

References 18 publications

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“…The insonation angle was usually Ͻ30°, and the sample volume was adjusted to cover the entire vessel and thus allow for optimal color resolution, sensitivity, and frame rate. The pulsatility index (PI), calculated as peak systolic frequency Ϫ end-diastolic frequency Ϭ mean, was measured as an index of downstream flow impedance (20,25). Uterine and umbilical artery end-diastolic flow, the presence/ absence of uterine artery diastolic notching, and the umbilical artery systolic flow-to-end-diastolic flow ratio (S/D ratio) were also assessed as indexes of downstream impedance to flow.…”

Section: Methodsmentioning

confidence: 99%

Suppression of trophoblast uterine spiral artery remodeling by estrogen during baboon pregnancy: impact on uterine and fetal blood flow dynamics

Aberdeen

Bonagura

Harman

et al. 2012

American Journal of Physiology-Heart and Circulatory Physiology

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The present study was conducted to determine the impact of suppressing trophoblast remodeling of the uterine spiral arteries by prematurely elevating estrogen levels in the first trimester of baboon pregnancy on uterine and umbilical blood flow dynamics. Uteroplacental blood flow was assessed by Doppler ultrasonography after acute administration of saline (basal state) and serotonin on days 60, 100, and 160 of gestation (term: 184 days) to baboons in which uterine spiral artery remodeling had been suppressed by the administration of estradiol on days 25-59 of gestation. Maternal blood pressure in the basal state was increased (P < 0.01), and uterine artery diastolic notching and the umbilical artery pulsatility index and systolic-to-diastolic ratio, reflecting downstream flow impedance, were increased (P < 0.01) after serotonin administration on day 160, but not earlier, in baboons treated with estradiol in early gestation. These changes in uteroplacental flow dynamics in serotonin-infused, estradiol-treated animals were accompanied by a decrease (P < 0.05) in uterine and umbilical artery volume flow and fetal bradycardia. The results of this study show that suppression of uterine artery remodeling by advancing the rise in estrogen from the second trimester to the first trimester disrupted uteroplacental blood flow dynamics and fetal homeostasis after vasochallenge late in primate pregnancy.

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Section: Methodsmentioning

confidence: 99%

Suppression of trophoblast uterine spiral artery remodeling by estrogen during baboon pregnancy: impact on uterine and fetal blood flow dynamics

Aberdeen

Bonagura

Harman

et al. 2012

American Journal of Physiology-Heart and Circulatory Physiology

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show abstract

“…Three separate measurements were obtained during periods of fetal rest and apnea from each frozen image captured from at least five consecutive uniform flow waveforms with a high signal-to-noise ratio. Pulsatility index (PI) (21,25) and resistance index (RI) were measured, and uterine and umbilical artery end-diastolic flow and the presence or absence of uterine artery diastolic notching were noted.…”

Section: Methodsmentioning

confidence: 99%

Uterine and fetal blood flow indexes and fetal growth assessment after chronic estrogen suppression in the second half of baboon pregnancy

Aberdeen

Baschat²,

Harman³

et al. 2010

American Journal of Physiology-Heart and Circulatory Physiology

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Although estrogen regulates important aspects of maternal cardiovascular physiology, the role of estrogen on uteroplacental and fetal blood flow is incompletely understood. This study tested the hypothesis that chronically suppressing endogenous estrogen production during the second half of baboon pregnancy alters uterine and fetal blood flow dynamics assessed by ultrasonography. Pregnant baboons were untreated or treated daily with the aromatase inhibitor letrozole or letrozole plus estradiol on days 100-160 of gestation (term = 184 days). Blood flow dynamics were determined by Doppler ultrasonography on day 60 and longitudinally between days 110 and 160 of gestation. Letrozole decreased maternal serum estradiol and estrone concentrations by 95% (P < 0.001). Fetal growth biometrical parameters increased (P < 0.001) between days 110 and 160 of gestation and were similar in untreated and letrozole-treated animals. Uterine, umbilical, and fetal middle cerebral artery pulsatility index and resistance index declined (P < 0.01) by 30-50% and uterine artery volume flow increased sixfold (P < 0.001) between days 60 and 160, but values were similar in untreated, letrozole-treated, and letrozole plus estradiol-treated baboons. Thus uterine and fetal artery blood flow indexes, uterine artery volume flow, and fetal growth were maintained at normal levels despite chronic estrogen suppression in the second half of baboon pregnancy. This suggests that elevated levels of endogenous estrogen are not required to maintain low impedance blood flow within the uteroplacental vascular bed during the second half of nonhuman primate pregnancy.

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“…In the present study, transabdominal ultrasound was performed to estimate body weight of fetuses [14], and fetuses were considered normal growth when body weight was within B 1.5 SD of the norm [15]. In a longitudinal study, the following indicators were then first measured at weeks 20-24 of pregnancy: V max was measured as the peak of the systolic blood flow waveform [16][17][18]. In addition, PI and RI were calculated at the same time.…”

Section: Methodsmentioning

confidence: 99%

Prenatal Diagnosis of the Hemodynamics of Fetal Renal Disease by Color Doppler Ultrasound

Iura

Makinoda²,

Miyazaki³

et al. 2003

Fetal Diagn Ther

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Objective: Hemodynamic analysis of the fetal renal artery elucidated the function of the renal glomerulus and renal tubule in normal growth fetus and was weighed against fetal renal disease. Design: The subjects were fetuses from pregnant women who gave informed consent. There were 6 cases of polycystic kidney, 4 cases of hydronephrosis and 33 cases of fetuses presenting with normal growth. A longitudinal study was performed for normal growth fetuses. Using maximum systolic velocity (V_max), pulsatility index (PI) and resistance index (RI), the blood flow was measured initially at 20–24 weeks of pregnancy and every 4 weeks thereafter. The measurement was performed 5 times in total. Also, for fetal renal disease, the measurement was performed using the same indexes. Results: In 2 cases of polycystic kidney, which led to death due to postpartum afunctional kidney, V_max indicated the lower level of less than mean –1.5 SD. In 1 case of single hydronephrosis, the single afunctional kidney was observed postpartum due to blood flow disruption. In 7 cases of normal renal function after birth, it indicated the lower level in some gestational ages but was generally in the normal range. Conclusions: Using indexes to evaluate the glomerulus and renal tubule of fetal renal disease, mean –1.5 SD of V_max can be considered to be the lower limit in the normal range and expected to be an important factor for the final outcome.

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Development of quantitative Doppler indices for uteroplacental and fetal blood flow during the third trimester

Cited by 27 publications

References 18 publications

Suppression of trophoblast uterine spiral artery remodeling by estrogen during baboon pregnancy: impact on uterine and fetal blood flow dynamics

Suppression of trophoblast uterine spiral artery remodeling by estrogen during baboon pregnancy: impact on uterine and fetal blood flow dynamics

Uterine and fetal blood flow indexes and fetal growth assessment after chronic estrogen suppression in the second half of baboon pregnancy

Prenatal Diagnosis of the Hemodynamics of Fetal Renal Disease by Color Doppler Ultrasound

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