Doppler assessment of the fetoplacental circulation in normal and growth-retarded fetuses

Reuwer, Paul; Bruinse, Hein W.; Stoutenbeek, P.; Haspels, A.A.

doi:10.1016/0028-2243(84)90117-5

Cited by 105 publications

(28 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The PI from the UA shows a significant decrease during the third trimester of pregnancy, reflecting a reduction in placental vascular resistance, as has been established by other studies (7)(8)(9)(10). The PI from the fetal ICA shows a fairly constant pattern up to 32-33 wk of gestation followed by a decrease toward term.…”

Section: Discussionsupporting

confidence: 79%

Fetal Internal Carotid and Umbilical Artery Blood Flow Velocity Waveforms as a Measure of Fetal Weil-Being in Intrauterine Growth Retardation

et al. 1988

View full text Add to dashboard Cite

ABSTRACT. Maximal flow velocity waveforms were recorded on one occasion from the umbilical artery (UA) and fetal internal carotid artery (ICA) in 240 normal pregnancies and 44 cases of intrauterine growth retardation between 26 and 39 wk of gestation. In normal pregnancy the mean UA pulsatility index (PI) decreased from 1.14 (SD: 20.13) at 26-27 wk of gestation to 0.78 (SD: k0.15) at 38-39 wk. The corresponding decrease in ICA PI was from 1.63 (SD: 20.19) to 1.31 (SD: f 0.21). Mean values of UA PI for normal pregnancies were linearly related to gestational age; for ICA PI this relation appeared to be quadratic. Normal limits according to age were constructed by estimated means 2 2 SD. In intrauterine growth retardation, the UA PI was increased (>2 SD) in 80% of cases, ICA PI was reduced (>2 SD) in only 45%. The outcome of fetuses with intrauterine growth retardation, as expressed by fetal heart rate abnormality, Apgar score at 1 min, and umbilical cord pH, was significantly related to the UA PI but not to the ICA PI. (Pediatr Res 24: [609][610][611][612]1988) Abbreviations FHR, fetal heart rate ICA, internal carotid artery IUGR, intrauterine growth retardation PI, pulsatility index UA, umbilical artery Recently, a Doppler ultrasound method for recording the blood flow velocity waveform in the fetal internal carotid artery was described (1).Preliminary results suggested that in IUGR due to impaired placental perfusion there was a higher percentage of abnormal PI values in the UA than in the ICA (2). It was also suggested that the reduction in ICA PI reflects redistribution of blood flow in the fetus with the aim of maintaining optimal oxygen supply to the fetal brain (2). The question arises as to if this redistribution of blood flow reflects a further deterioration in fetal oxygen supply in the presence of IUGR.The objective of the present study was 3-fold: I) to establish the normal distribution of UA PI and ICA PI during the third trimester of pregnancy; 2) to determine the degree of abnormality of UA PI and ICA PI during this period of gestation in the presence of IUGR due to impaired placental perfusion; 3) to relate UA PI and ICA PI to fetal well-being as expressed by antenatal fetal heart rate patterns before delivery, Apgar score at 1 min, and umbilical arterial pH. SUBJECTS AND METHODSA combined mechanical sector and pulsed Doppler system (Diasonics CV 400) with a carrier frequency of 3.5 and 3 MHz was used for blood flow velocity measurements in the fetal internal carotid artery and UA. The energy output of the pulsed Doppler transducer was 1.5 mW/cm2 (spatial peak, temporal average). The maximum flow velocity waveform in the internal carotid artery was obtained at the level of the bifurcation into the middle and anterior cerebral artery (1). The sample size of the Doppler probe, necessary for sampling frequency shifts originating from the moving erythrocytes within a vessel, was 4 mm. This allowed clear signals from the internal carotid artery without interference from other nearby vessels such as t...

show abstract

Section: Discussionsupporting

confidence: 79%

Fetal Internal Carotid and Umbilical Artery Blood Flow Velocity Waveforms as a Measure of Fetal Weil-Being in Intrauterine Growth Retardation

et al. 1988

View full text Add to dashboard Cite

show abstract

“…In the literature of Doppler flow velocity waveform (FVW) analysis of the umbilical artery, several authors describe characteristic changes (a diminished end-diastolic flow) in the FVW in combination with intrauterine growth retardation (IUGR) [1,2,3,6,12,13,17]. A decreased end-diastolic flow is reported to be indicative of increased fetal placental resistance.…”

Section: Introductionmentioning

confidence: 99%

“…-Pulsatility Index (PI) [4], is defined as the difference between peak-systolic and enddiastolic flow, divided by the mean flow ((A -B)/mean). Good negative correlations between fetal growth and the PI of the umbilical artery [2,11,12] and the fetal descending aorta [6] are reported, even weeks to months before IUGR was suspected clinically.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of three indices of umbilical blood flow in relation to prediction of growth retardation

Mulders¹,

Wijn²,

Jongsma³

et al. 1987

Journal of Perinatal Medicine

View full text Add to dashboard Cite

“…Antenatal Doppler studies have demonstrated that fetal hypoxia is associated with an increase in umbilical artery resistance. The increased resistance is probably due to vasoconstriction and hypertrophy of the placental vessels [4]. If our hypothesis is correct, SGA infants with clotting abnormalities would also have liver dysfunction associated with abnormal antenatal umbilical artery Doppler studies.…”

Section: Introductionmentioning

confidence: 99%

Neonatal Coagulopathy in Preterm, Small-for-Gestational-Age Infants

Hannam¹,

Lees

Edwards

et al. 2003

Neonatology

View full text Add to dashboard Cite

Our aim was to determine if antenatal hypoxia was associated with liver dysfunction and coagulation abnormalities in small-for-gestational-age (SGA) infants. Sixteen SGA infants, median gestational age 30 (range 26–32) weeks, who consecutively had had umbilical artery Doppler studies in the week before delivery, were compared to appropriate-for-gestational-age (AGA) controls, who were each matched to an SGA infant for gestational age. The median international normalised ratio (INR) was significantly higher (1.9 vs. 1.3, p < 0.001) and the neutrophil (p = 0.003) and platelet counts (p < 0.001), alkaline phosphatase (p < 0.001) and albumin (p < 0.02) levels significantly lower in the SGA compared to the AGA group. The umbilical artery pulsatility index (PI) was elevated, indicating antenatal hypoxia, in all but 1 of the SGA infants. Multiple linear regression analysis demonstrated that the INR was significantly related to the umbilical artery PI independent of the other variables (p = 0.0002, R² = 0.71). These results suggest that the coagulopathy seen in preterm SGA infants might at least be partially explained by antenatal hypoxia affecting the liver and hence vitamin K-dependent coagulation.

show abstract

Doppler assessment of the fetoplacental circulation in normal and growth-retarded fetuses

Cited by 105 publications

References 6 publications

Fetal Internal Carotid and Umbilical Artery Blood Flow Velocity Waveforms as a Measure of Fetal Weil-Being in Intrauterine Growth Retardation

Fetal Internal Carotid and Umbilical Artery Blood Flow Velocity Waveforms as a Measure of Fetal Weil-Being in Intrauterine Growth Retardation

A comparative study of three indices of umbilical blood flow in relation to prediction of growth retardation

Neonatal Coagulopathy in Preterm, Small-for-Gestational-Age Infants

Contact Info

Product

Resources

About