Umbilical venous blood flow and its measurement in the human fetus

Najafzadeh, Afrooz; Dickinson, Jan E.

doi:10.1002/jcu.21970

Cited by 28 publications

(29 citation statements)

References 69 publications

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“…UVVF was calculated using previously published methods. 9,11,14 Methods of optimal UVVF calculation were employed: the umbilical…”

Section: Uvvf and Cco Calculationmentioning

confidence: 99%

“…Umbilical venous volume flow (UVVF) is a validated, noninvasive method of measuring fetal placental blood flow and can be performed during routine fetal ultrasound. [9][10][11][12] Data suggests UVVF reflects placental rather than fetal characteristics: a study of monochorionic twins with selective intrauterine growth restriction demonstrated the discrepancy in in-utero UVVF reflected placental share at birth, rather than the discrepancy in birth weights. 13 To date, UVVF has not been measured in fetuses with CHD, and it is unknown whether flow through the placenta differs in these fetuses compared to normal.…”

Section: Introductionmentioning

confidence: 99%

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Mid‐gestational fetal placental blood flow is diminished in the fetus with congenital heart disease

Josowitz

Katcoff

et al. 2020

Prenatal Diagnosis

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Objective: Data suggest fetuses with congenital heart disease (CHD) have placental abnormalities. Their abnormal placental vasculature may affect fetal placental blood flow, which has not previously been explored. Method: We performed a retrospective cross-sectional study comparing umbilical venous volume flow (UVVF) of single ventricle, D-transposition of the great arteries, and tetralogy of Fallot fetuses with fetuses without CHD. UVVF and combined cardiac output (CCO) were calculated from fetal echocardiography and compared using t tests, χ 2 and Fisher's exact tests. Results: Mean gestational age and fetal weight were greater in CHD fetuses (26.5 weeks, 1119.4 g; n = 81, P < .001) compared to controls (23.1 weeks, 675 g; n = 170, P < .001). UVVF/fetal weight was nevertheless decreased among cases (99.8 vs 115.3 mL/min/kg, P < .001). Subgroup analysis of 20-to 25-week fetuses demonstrated no significant differences in case and control baseline characteristics. In CHD fetuses (n = 31) compared to controls (n = 144), absolute UVVF (50.8 vs 62.1 mL/min, P = .006), and UVVF/fetal weight (98.8 vs 118.5 mL/min/kg, P < .001) were decreased. Findings were similar in single ventricle (n = 24) and hypoplastic left heart syndrome (n = 14). Conclusion: Mid-gestational placental blood flow in CHD fetuses is decreased compared to controls. Further study is needed to explore the relationship between UVVF and placental pathology, and impact on outcomes.

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“…UVVF was calculated using previously published methods. 9,11,14 Methods of optimal UVVF calculation were employed: the umbilical…”

Section: Uvvf and Cco Calculationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mid‐gestational fetal placental blood flow is diminished in the fetus with congenital heart disease

Josowitz

Katcoff

et al. 2020

Prenatal Diagnosis

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“…Pulsatile waveform appears in the umbilical vein in starting of the first trimester of pregnancy but it completely disappears after 13 gestational weeks. Pulse in the umbilical vein is also associated with pathological conditions and is the most commonly used sign for measuring cardiac performance in umbilical vein [26,27].…”

Section: Introductionmentioning

confidence: 99%

Simulation and Analysis of Umbilical Blood Flow using Markov-based Mathematical Model

Queyam¹,

Pahuja²,

Singh³

2017

IJISA

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Abstract-The intra-uterine development of the fetus depends on various factors, one such critical factor is umbilical blood flow because the quantity of oxygen delivered to the placenta and to the fetus is directly limited by umbilical blood flow rate. Since the measurement of the hemodynamic quantities such as blood pressure and blood flow rate is not possible in utero hence the use of patient-specific mathematical modeling is beneficial for the assessment of feto-maternal wellbeing. A Markov model based mathematical model of fetal circulation is developed by taking three node concept. The fetus, the umbilical cord, and the placenta represent the 3 nodes of Markov model. A LabVIEWbased virtual instrument is designed to simulate the mathematical model which results in waveform similar to Doppler blood flow velocimetry of umbilical artery. The model is simulated at various degree of conductivity of the umbilical cord to the oxygenated blood. Simulation results show that the umbilical artery blood flow velocity waveform depends on gestation age, fetal heart rate, uterine contraction and placental insufficiency. The Doppler indices calculated from simulation helps in predicting both fetal and maternal abnormalities at various degrees of the conductivity to the blood flow passage. Therefore, integrating patient-specific models along with established medical equipments will be helpful in identifying true intra-uterine growth restricted fetuses from normal fetuses and helps clinicians to take timely interventions.

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“…The quantitative assessment of the absolute venous flow volume was conducted using methodologies previously described . They also normalised the venous flow volume per unit of fetal abdominal circumference.…”

Section: Introductionmentioning

confidence: 99%

Stress and preterm birth: biological and vascular mechanisms affecting the feto‐placental circulation and the length of gestation

Najafzadeh

2016

Sonography

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Preterm birth is the leading cause of perinatal morbidity and mortality. Women experiencing high levels of stress in pregnancy are at an increased risk of preterm delivery. This review examines the biological pathways of the maternal stress response, in particular, the functioning of the maternal hypothalamic-pituitary-adrenal axis, and investigates the role of the placenta in altering this response mechanism. Furthermore, the impact of the products of hypothalamic-pituitary-adrenal axis on the blood flow resistance of the feto-placental arteries is explained. Prior Doppler studies of maternal stress were reviewed. The study of correlations between maternal stress and resistive indices of feto-placental arteries was common themes in these studies. Their conclusions, however, were inconsistently explained by their methodological differences and limited control for potential confounders. The biological mechanisms of stress control provide the impression that it is plausible that antenatal stress could affect the placental function and influence preterm delivery, but to date, this has not been conclusively established. If the investigation is further expanded to include measures of fetal biometry, additional blood vessels and an assessment over a longer period in gestation, subtle changes in the feto-placental blood supply may be revealed, and a link to preterm birth is feasible.

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Umbilical venous blood flow and its measurement in the human fetus

Cited by 28 publications

References 69 publications

Mid‐gestational fetal placental blood flow is diminished in the fetus with congenital heart disease

Mid‐gestational fetal placental blood flow is diminished in the fetus with congenital heart disease

Simulation and Analysis of Umbilical Blood Flow using Markov-based Mathematical Model

Stress and preterm birth: biological and vascular mechanisms affecting the feto‐placental circulation and the length of gestation

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