Is there any relation between umbilical artery and vein diameter and estimated fetal weight in healthy pregnant women?

Köşüş, Aydın; Köşüş, Nermin; Turhan, Nilgün Öztürk

doi:10.1007/s10396-012-0360-0

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…We suspect that the small size and weight of our preterm minipigs were associated with smaller umbilical vessel diameters than those present in the previously described fetal sheep models of the AP (Köşüş et al, 2012). Umbilical vessel cannulation further reduces the diameter and area of the vessel by the wall thickness of the cannula, which becomes more significant as vessel size and distensibility decreases.…”

Section: Discussionmentioning

confidence: 70%

“…We speculate that the changes in RV function were induced by excessive RV afterload caused by (1) supraphysiologic circuit resistance (Miura et al, 2012;Reoma et al, 2009); and (2) excessive total peripheral resistance caused by a heightened sympathetic nervous system (SNS) in response to low UV flow and the consequent impairment of venous return. We suspect that the small size and weight of our preterm minipigs were associated with smaller umbilical vessel diameters than those present in the previously described fetal sheep models of the AP (Köşüş et al, 2012). Umbilical vessel cannulation further reduces the diameter and area of the vessel by the wall thickness of the cannula, which becomes more significant as vessel size and distensibility decreases.…”

Section: Discussionmentioning

confidence: 75%

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Achieving sustained extrauterine life: Challenges of an artificial placenta in fetal pigs as a model of the preterm human fetus

et al. 2021

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Artificial placenta (AP) technology aims to maintain fetal circulation, while promoting the physiologic development of organs. Recent reports of experiments performed in sheep indicate the intrauterine environment can be recreated through the cannulation of umbilical vessels, replacement of the placenta with a low‐resistance membrane oxygenator, and incubation of the fetus in fluid. However, it remains to be seen whether animal fetuses similar in size to the extremely preterm human infant that have been proposed as a potential target for this technology can be supported in this way. Preterm Yucatan miniature piglets are similar in size to extremely preterm human infants and share similar umbilical cord anatomy, raising the possibility to serve as a good model to investigate the AP. To characterize fetal cardiovascular physiology, the carotid artery (n = 24) was cannulated in utero and umbilical vein (UV) and umbilical artery were sampled. Fetal UV flow was measured by MRI (n = 16). Piglets were delivered at 98 ± 4 days gestation (term = 115 days), cannulated, and supported on the AP (n = 12) for 684 ± 228 min (range 195–3077 min). UV flow was subphysiologic (p = .002), while heart rate was elevated on the AP compared with in utero controls (p = .0007). We observed an inverse relationship between heart rate and UV flow (r2 = .4527; p < .001) with progressive right ventricular enlargement that was associated with reduced contractility and ultimately hydrops and circulatory collapse. We attribute this to excessive afterload imposed by supraphysiologic circuit resistance and augmented sympathetic activity. We conclude that short‐term support of the preterm piglet on the AP is feasible, although we have not been able to attain normal fetal physiology. In the future, we propose to investigate the feasibility of an AP circuit that incorporates a centrifugal pump in our miniature pig model.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 75%

Achieving sustained extrauterine life: Challenges of an artificial placenta in fetal pigs as a model of the preterm human fetus

et al. 2021

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“…Among the limited studies on the umbilical vein of normal foetuses, investigations into the relationship between umbilical vein diameter and GA, flow velocity and GA and flow volume and GA have been conducted ( 14 , 15 ). Foetal umbilical vein diameter and flow velocity showed a significant positive correlation with GA over a longer period from 20 to 40 weeks of GA ( 16 – 18 ). This study opted to only include foetuses in the third trimester due to the large variation in foetal weight and rapid rate of weight gain at the same GA during this period.…”

Section: Discussionmentioning

confidence: 95%

Value of foetal umbilical vein standardised blood flow volume in predicting weight gain in the third trimester: a prospective case-cohort study

Fang,

Shi,

Zhang

et al. 2024

Front. Pediatr.

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ObjectiveThis study aims to establish a prediction model of foetal umbilical vein standardised blood flow volume (sQuv) on estimated foetal weight (EFW) in the third trimester.MethodsA case-cohort study involving 200 eligible normal foetuses was conducted at the Ultrasound Department of Longquanyi District of Maternity and Child Healthcare Hospital between June 1, 2020 and December 31, 2021. Ultrasound measurements were taken at two separate intervals to assess EFW and the rate of EFW (rEFW) [first: between 28 w and 33 w6d of gestational age (GA); second: after 4–6 weeks]. Umbilical vein blood flow volume (Quv) and sQuv (normalised with EFW) were calculated only during the initial measurement. Using general linear regression, a prediction model for EFW based on GA and sQuv was developed, with the gestational week employed as a calibration scalar and validated using linear regression cross-validation.ResultsIn the third trimester, EFW exhibited significant correlations with GA, abdominal circumference (AC), head circumference (HC) and Quv (all ρ > 0.6, P < 0.001). Furthermore, the rEFW showed significant correlations with Quv and sQuv (all ρ > 0.6, P < 0.001). A linear regression equation was established using a general linear regression model: rEFW = 0.32689 × sQuv. Additionally, a foetal weight prediction model (EFW = −2,554.6770 + 0.9655 × sQuv + 129.6916 × GA) was established using sQuv. The above two formulas were cross-validated by intra-group linear regression and proved to be of good efficacy.ConclusionsIn the third trimester, EFW displayed significant correlations with GA, AC, HC and Quv. Additionally, the rEFW exhibited significant correlations with Quv and sQuv. The sQuv during the third trimester has predictive value for foetal weight, serving as an early warning indicator.

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“…Wang also included a narrower intra‐hepatic portion in the measurements. The curves of Weissman, 82 Kosus, 84 and Barbieri 83 are all based on measurements of the extra‐abdominal part of the umbilical vein.…”

Section: Discussionmentioning

confidence: 99%

“…In total, five reference curves for the umbilical vein diameter are published, all based on low-risk cohorts. 6,[82][83][84][85] The curves of Mahony 6 (n = 150) and Wang 85 (n = 907) are both based on measurements of the intra-abdominal part of the umbilical vein. Wang also included a narrower intra-hepatic portion in the measurements.…”

Section: Reference Curvesmentioning

confidence: 99%

Isolated fetal umbilical vein varix and the association with intrauterine fetal death and fetal growth restriction: A systematic review, meta‐analysis, and nested retrospective cohort study

Koorn,

Heinrich,

Nelissen

et al. 2024

Prenatal Diagnosis

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ObjectivesTo assess the risk of intrauterine fetal death (IUFD) and fetal growth restriction (FGR) in fetuses with an isolated fetal intra‐abdominal umbilical vein varix (i‐FIUVV).MethodsA retrospective cohort study combined with a systematic review and meta‐analysis of the literature was performed. In the retrospective cohort study, all singleton fetuses with an i‐FIUVV in the fetal medicine units of the Amsterdam UMC (between 2007 and 2023) were analyzed. The primary outcome measures were IUFD and FGR. The sample proportions of IUFD and FGR were depicted as risk percentages. The IUFD proportion was compared to the regional reference population and the FGR proportion was compared to the reported proportions in Europe. The secondary outcome measures were gestational age at diagnosis, initial and maximal FIUVV diameter, fetal monitoring in pregnancy, turbulent flow in the varix, thrombus formation in the varix, induction of labor, gestational age at birth, and birthweight centile. The proportion of fetuses with a birthweight below the 10th centile was compared with that of the regional reference population. The systematic review included all cases from eligible literature published between 2007 and 2023 supplemented by the data of our retrospective cohort study. In the systematic review and meta‐analysis, the pooled proportions of IUFD and FGR were assessed in fetuses with i‐FIUVV.ResultsThe retrospective cohort included 43 singletons with an i‐FIUVV. The IUFD risk was 0% [Confidence Interval, CI: 0%–8.2%], which did not differ significantly from 0.3% in the reference population, p = 1.0. The risk of FGR was 16.3% [CI: 6.8%–30.7%] in the studied population, which is higher than the reported incidence of FGR in Europe ranging from 5%–10%. The proportion of fetuses with birthweights below the 10th centile was higher in our cohort compared with the reference population (23.3 vs. 9.9%, p < 0.01). The systematic review included 12 articles, three abstracts, and our current cohort. In total, 513 cases with an i‐FIUVV were included. The pooled risk was 0.4% [CI: 0.1%–1.7%] for IUFD and 5.2% [CI: 1.1%–21.3%] for FGR. The mean gestational age at birth did not exceed 39 weeks in neither the cohort (38.7 weeks) nor the pooled literature (37.6 weeks).ConclusionAn i‐FIUVV in singletons is not associated with an increased IUFD risk up to 39 weeks of gestation but is possibly associated with FGR. The incidence of FGR in our cohort was higher than in the pooled literature (16.3% vs. 5%) but FGR definitions in the included studies varied. The proportion of birthweights below the 10th percentile in our cohort was significantly higher than in the reference group. Thus, based on these findings, we suggest conducting sonographic growth assessments while simultaneously assessing the i‐FIUVV. No further monitoring and follow‐up are indicated up to 39 weeks of gestation. After 39 weeks of gestation, data on fetuses with i‐FIUVV and their outcomes are lacking.

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Is there any relation between umbilical artery and vein diameter and estimated fetal weight in healthy pregnant women?

Abstract: Based on these findings, it is not possible at present to recommend the use of umbilical vessel diameters for prediction of EFW after 34 weeks, but it may be helpful under 34 weeks. UV/UA ratio is not useful for prediction and management of complicated pregnancies.

Cited by 7 publications

References 27 publications

Achieving sustained extrauterine life: Challenges of an artificial placenta in fetal pigs as a model of the preterm human fetus

Achieving sustained extrauterine life: Challenges of an artificial placenta in fetal pigs as a model of the preterm human fetus

Value of foetal umbilical vein standardised blood flow volume in predicting weight gain in the third trimester: a prospective case-cohort study

Isolated fetal umbilical vein varix and the association with intrauterine fetal death and fetal growth restriction: A systematic review, meta‐analysis, and nested retrospective cohort study

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