Doppler Velocimetry in Branch Pulmonary Arteries of Normal Human Fetuses during the Second Half of Gestation

Ja, Laudy; Ridder, de H Huib; Jw, Wladimiroff

doi:10.1203/00006450-199706000-00016

Cited by 50 publications

(67 citation statements)

References 17 publications

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“…Information on normal fetal pulmonary circulation has been obtained in our center. 10,11 As a result, gestation-related changes in pulmonary blood flow velocity waveforms have been reported by us. 10,11 Only sparse data are available on the inverse relationship between Po 2 and downstream impedance in the peripheral pulmonary arteries, established in growth-restricted human fetuses.…”

supporting

confidence: 51%

“…10,11 As a result, gestation-related changes in pulmonary blood flow velocity waveforms have been reported by us. 10,11 Only sparse data are available on the inverse relationship between Po 2 and downstream impedance in the peripheral pulmonary arteries, established in growth-restricted human fetuses. 12 It has been shown in postmortem studies that pulmonary hypoplasia is associated with underdevelopment and structural changes of the pulmonary vascular bed.…”

supporting

confidence: 51%

“…Doppler waveforms (sample volume: 0.1-0.3 cm) were first obtained from the most proximal branch of the pulmonary artery, then in the middle lung region at equal distance from the outer border of the heart and the inner thoracic wall and subsequently in the distal lung region as close as possible to the fetal inner thoracic wall (Fig 1). 10,11 The interrogation angle was always kept below 20 degrees. The highpass filter was set at 100 Hz, and when no end-diastolic or early diastolic reverse flow velocities were present, the filter was set at 70 Hz.…”

Section: Recording Techniquementioning

confidence: 99%

“…The flow velocity waveform pattern at all 3 levels has been described previously. 10,11 Adequate accuracy and precision of the recording technique was achieved in a separate control group. 11 Clinicians were blinded to the Doppler results.…”

Section: Recording Techniquementioning

confidence: 99%

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Prenatal Prediction of Pulmonary Hypoplasia: Clinical, Biometric, and Doppler Velocity Correlates

et al. 2002

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ABSTRACT. Objectives. To determine the value of pulmonary artery Doppler velocimetry relative to fetal biometric indices and clinical correlates in the prenatal prediction of lethal lung hypoplasia (LH) in prolonged (>1 week) oligohydramnios.Methods. Forty-two singleton pregnancies with oligohydramnios associated with premature rupture of membranes ([PROM]; n ‫؍‬ 31) or bilateral renal pathology (n ‫؍‬ 11) were examined using color-coded Doppler ultrasound in a cross-sectional study design. Mean gestational age was 28.0 ؎ 4.3 weeks (range: 20 -36 weeks). Thoracic, cardiac, and abdominal circumference and the largest vertical amniotic fluid pocket were measured. Pulsed Doppler measurements of the arterial pulmonary branches were made at the level of the cardiac 4-chamber view. Diagnosis of LH was based on clinical, radiologic, and pathologic criteria. Clinicians were blinded to the prenatal measurements.Results. The prevalence of lethal LH was 43%. In the PROM subset, combination of onset of PROM at <20 weeks, duration of oligohydramnios at >8 weeks, and degree of oligohydramnios at <1 cm presented the highest clinical prediction rate for lethal LH. For both the total group and the PROM subset, the highest prediction rate for lethal LH was presented by thoracic circumference/ abdominal circumference ratio, peak systolic velocity in the proximal branch, and time-averaged and end-diastolic velocity in the middle branch of the pulmonary artery. In the PROM subset, the combination of all 3 clinical, biometric, and Doppler parameters revealed the most favorable combination to predict lethal LH (positive predictive value: 100%; accuracy: 93%; and sensitivity: 71%).Conclusion. Doppler velocimetry may detect changes in pulmonary artery waveforms in the presence of LH but fails to be the ultimate test for the prenatal prediction of lethal LH. The best prediction can be achieved by combining clinical, biometric, and Doppler parameters. Pediatrics 2002;109:250 -258; human fetus, pulmonary hypoplasia, pulmonary circulation, premature rupture of membranes, oligohydramnios, Doppler velocimetry.

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supporting

confidence: 51%

supporting

confidence: 51%

Section: Recording Techniquementioning

confidence: 99%

Section: Recording Techniquementioning

confidence: 99%

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Prenatal Prediction of Pulmonary Hypoplasia: Clinical, Biometric, and Doppler Velocity Correlates

et al. 2002

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“…Nevertheless, pulsed Doppler has been shown to contribute importantly to the understanding of fetal heart function and fetal circulation in both normal fetuses and those with disease. Normative data are available that define blood flow patterns and peak velocities through the mitral and tricuspid valves, 207 aortic and pulmonary valves, 208,209 branch pulmonary arteries, 210 aortic isthmus, 211 ductus arteriosus, 209 and pulmonary 212 and systemic veins. 213 Pulsed Doppler interrogation of the ventricular inflows, systemic and pulmonary veins, ductus venosus, and umbilical vein provides clues to the diastolic properties and filling of the ventricles not obtainable with color Doppler.…”

Section: Doppler Imagingmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

1,016

543

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Background— The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.

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Long-term survival following delayed presentation and resection of colorectal liver metastases (Br J Surg 2011: 98: 1309–1317)

Garden

2011

British Journal of Surgery

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Der Stellenwert von Wasserstoffbrücken und π‐Stapelung in isolierten „kalten“ Komplexen aus 2‐Pyridon (2PY) und 1,2,4,5‐Tetrafluorbenzol (4FB), Pentafluorbenzol (5FB) sowie Hexafluorbenzol (6FB) wurde untersucht. Lediglich für 2PY⋅6FB in der Gasphase wurde eine π‐Stapelung und ein breites UV‐Spektrum beobachtet, die übrigen 2PY⋅nFB‐Komplexe zeigten die für Dimere mit zwei Wasserstoffbrücken charakteristischen, gut aufgelösten Absorptionsspektren (siehe Bild).

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Doppler Velocimetry in Branch Pulmonary Arteries of Normal Human Fetuses during the Second Half of Gestation

Cited by 50 publications

References 17 publications

Prenatal Prediction of Pulmonary Hypoplasia: Clinical, Biometric, and Doppler Velocity Correlates

Prenatal Prediction of Pulmonary Hypoplasia: Clinical, Biometric, and Doppler Velocity Correlates

Diagnosis and Treatment of Fetal Cardiac Disease

Long-term survival following delayed presentation and resection of colorectal liver metastases (Br J Surg 2011: 98: 1309–1317)

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