The fetal portal vein: normal blood flow development during the second half of human pregnancy

Kessler, Jörg; Rasmussen, Svein; Kiserud, Torvid

doi:10.1002/uog.4054

Cited by 47 publications

(46 citation statements)

References 40 publications

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“…The assumption that the velocity profile is parabolic, i.e., h ϭ 0.5, may not be valid under all conditions (38). However, three recent publications showed excellent agreement between both methods for flow calculation in the UV (14,22) and the PV (18), which is reassuring for the method applied in this study. The data presented in this study confirm the flow estimates of some recent studies (14,15,22,31), but somehow lower than others (13,16,30,33) possibly because of sampling site, insonation technique, and diameter measurements as discussed previously (14).…”

Section: Discussionmentioning

confidence: 56%

“…The participating women had a mean BW of 3360 Ϯ 520 g, a prepregnancy BMI of 23.4 Ϯ 3.8 and mean average pregnancy weight gain of 0.36 Ϯ 0.14 kg/wk. Further characteristics of the study population have been published earlier (18). A total 655 examinations were done (median 4 per participant, range 1-5).…”

Section: Resultsmentioning

confidence: 99%

“…The study protocol was approved by the Regional Committee for Medical Research Ethics (REK-Vest 04/3837) and the women were recruited after informed written consent. We previously reported on DV flow velocities (17) and blood flow in the PV (18) and the left PV (LPV) (19). 1 Subjects.…”

Section: Methodsmentioning

confidence: 99%

“…The angle of insonation was kept as low as possible and always Յ30 degrees. The measurement techniques for the UV, the DV, the LPV, and PV have been described in detail (15,18,22).…”

Section: Measurementmentioning

confidence: 99%

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Longitudinal Study of Umbilical and Portal Venous Blood flow to the Fetal Liver: Low Pregnancy Weight Gain is Associated With Preferential Supply to the Fetal Left Liver Lobe

et al. 2008

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Recent data suggest that umbilical venous perfusion of the fetal liver has an important influence on fetal growth and postnatal liver function, and that maternal factors in late pregnancy modify this circulation. In a longitudinal study of 160 low-risk pregnancies, we determined how umbilical and portal venous blood flows to the fetal liver changed during gestation, and examined the hypothesis that maternal body mass index and pregnancy weight gain influenced fetal liver blood flows. We measured blood flows in the umbilical and portal veins, left portal branch, and ductus venosus using ultrasound. Normalizing for estimated fetal weight, fetal liver total venous blood flow fell from 84 to 57 mL ⅐ min Ϫ1 ⅐ kg Ϫ1 during 21-39 wk of gestation; toward term the portal contribution increased (from 14 to 20%) and the umbilical contribution fell, whereas distribution between the left and right liver lobes was stable, 60%/ 40%. Greater flow of nutrient-rich umbilical venous blood to the liver was associated with higher birth weight and neonatal ponderal index. Maternal body mass index was not related to fetal liver blood flows, but low pregnancy weight gain strongly influenced flow distribution between the right and left liver lobes, sparing the left lobe and increasing the difference between lobes by 16%. T he developmental origins of health and disease hypothesis established a link between an adverse intrauterine environment and cardiovascular disease in adult life (1,2). There is strong evidence from epidemiologic studies and animal experiments that an adverse intrauterine environment is associated with raised levels of cardiovascular risk factors controlled by the liver (3). The role of the fetal liver for intrauterine growth and development has therefore come into focus of research.In fetal sheep, experimental reduction in umbilical venous liver perfusion results in decreased synthesis of insulin-like growth factors by the fetal liver, decreasing the cellular proliferation rate in peripheral tissues and impairing fetal growth (4,5). In human fetuses, venous liver blood flow was shown to be modulated by maternal diet and body composition (6).The fetal liver receives venous blood from the umbilical and portal veins (PVs). The umbilical vein (UV) directs nutrient-rich placental blood predominantly to the left liver lobe, whereas nutrient-depleted blood from the PV is directed to the right liver lobe (7). This selective perfusion pattern is thought to be the main reason for differences in micro architecture (8), hematopoiesis (9) and gene and enzyme expression (10,11).Although single components of the venous liver circulation such as umbilical blood flow (12-14) and shunting through the ductus venosus (DV) (15,16) have been investigated earlier, little is known about the distributions of umbilical and portal blood flows in the human fetus.The aim of the present study was to study simultaneously the umbilical and portal venous circulations and the blood flow distribution to the liver lobes in the second half of ...

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Section: Discussionmentioning

confidence: 56%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The angle of insonation was kept as low as possible and always Յ30 degrees. The measurement techniques for the UV, the DV, the LPV, and PV have been described in detail (15,18,22).…”

Section: Measurementmentioning

confidence: 99%

See 2 more Smart Citations

Longitudinal Study of Umbilical and Portal Venous Blood flow to the Fetal Liver: Low Pregnancy Weight Gain is Associated With Preferential Supply to the Fetal Left Liver Lobe

et al. 2008

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“…In one reported case, the major vascular connections within a shared liver were demonstrated postnatally and this significantly affected the surgical procedures that were performed 3 . Portal veins can be demonstrated by Doppler examination in 94% of fetuses that are more advanced than 20 weeks' gestation 4 , which implies that sonographic examination should be able to identify any major vascular connections from this gestational age onwards.…”

Section: Letters To the Editor Three-dimensional Power Doppler In Thementioning

confidence: 99%

Three‐dimensional power Doppler in the diagnosis and surgical management of thoraco‐omphalopagus conjoined twins

Wataganara

Sutanthaviboon

Ngerncham

et al. 2008

Ultrasound in Obstet & Gyne

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The Fetal Circulation

Thompson

Hashimoto

2012

Anesthesia and the Fetus

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The fetal portal vein: normal blood flow development during the second half of human pregnancy

Abstract: Objectives

Cited by 47 publications

References 40 publications

Longitudinal Study of Umbilical and Portal Venous Blood flow to the Fetal Liver: Low Pregnancy Weight Gain is Associated With Preferential Supply to the Fetal Left Liver Lobe

Longitudinal Study of Umbilical and Portal Venous Blood flow to the Fetal Liver: Low Pregnancy Weight Gain is Associated With Preferential Supply to the Fetal Left Liver Lobe

Three‐dimensional power Doppler in the diagnosis and surgical management of thoraco‐omphalopagus conjoined twins

The Fetal Circulation

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