The effect of maternal oxygen administration on fetal and maternal blood flow values using Doppler ultrasonography

Abstract

Thirty-one pregnant women divided into three groups (AGA prepartum, SGA prepartum without distress, AGA in labor) were examined using Doppler ultrasonography before, during and after oxygen administration to mothers via a face mask. The aim of the study was to find out if there was any effect on the blood flow values in the fetal aorta, the umbilical artery, the fetal common carotid artery and the uterine arcuate arteries. The resistance index (RI) did not change in those vessels during maternal hyperoxygenation with one exception: in the group of SGA fetuses the RI in the fetal aorta increased significantly. Blood flow velocity and volume blood flow remained unchanged in the fetal aorta during oxygen administration.

Fetal Hemodynamic Response to Maternal Oxygenation in Normal and Complicated Pregnancies

“…Many studies on IUGR fetuses have reported an unchanged UA-PI following MO [29,30,38,39]. This absence of a placental response may be due to dysfunctional placental oxygen transport in IUGR fetuses, which has been shown by MRI.…”

“…In healthy fetuses, umbilical cord hemodynamic Doppler parameters, such as UA-PI, UA systolic and diastolic velocity, and UV blood flow, remain unchanged during MO at various levels of O 2 supplementation [28][29][30]. However, MRI has revealed that both BOLD signals and R1 of the placenta increase significantly after high-flow oxygen inhalation (12-15 L/minute), even in the short term [21][22][23].…”

“…In the cerebrovascular hemodynamic response, vascular resistance and brain blood flow in healthy fetuses remain unchanged during MO, as evidenced by most Doppler observations [28][29][30][31]. The MCA is the most common vessel used to evaluate cerebral hemodynamics.…”

Maternal hyperoxygenation improves left heart filling in fetuses with atrial septal aneurysm causing impediment to left ventricular inflow

“…A lack of pulmonary vasoreactivity was shown to be poorly prognostic, predictive of fatal lung hypoplasia in conditions of potential lung under development. Investigators have used maternal hyperoxygenation to study intrauterine growth restriction, congenital diaphragmatic hernia, fetal lung hypoplasia and maternal pre‐eclampsia. Improvements in fetal circulatory Doppler flow patterns were demonstrated in growth‐restricted fetuses that received maternal hyperoxygenation.…”

“…The observation of fetal AAS with a small, thin, underfilled LV, ultimately manifesting as a completely normal LV after birth, has led us to investigate the possibility of recreating this phenomenon before birth. Maternal hyperoxygenation in the third trimester of pregnancy has been applied in a number of conditions, both from a diagnostic and therapeutic perspective. It can promote fetal pulmonary vasodilation, thereby influencing the quantity of pulmonary venous return to the left side of the heart.…”