Umbilical venous volume flow and fetal behavioral states in the normally developing fetus

Boito, Simona; Ursem, Nicolette; Struijk, P. C.; Stijnen, Theo; Wladimiroff, J. W.

doi:10.1002/uog.956

Cited by 21 publications

(13 citation statements)

References 21 publications

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“…Furthermore, the UV blood flow measured in our study (132 ± 38 mL/min/kg) was in keeping with previous studies by our group quantifying normal fetal circulation using PC‐MRI . Similar to the relative differences observed between MRI and US measured UTA blood flow, UV blood flow reported in this study is higher than that measured using US in normal fetuses …”

Section: Discussionsupporting

confidence: 91%

Uterine artery and umbilical vein blood flow are unaffected by moderate habitual physical activity during pregnancy

et al. 2019

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Objective: This study aims to noninvasively quantify blood flow in the uterine arteries (UTAs) and umbilical vein (UV) using phase-contrast magnetic resonance imaging (PC-MRI) and test whether these correlate with maternal fitness parameters. Method:Resting UTA and UV flows were measured in 23 healthy 30 ± 3-year-old women who engaged in moderate-intensity physical activity during pregnancy.Participant fitness was characterized in the second and third trimesters using the submaximal oxygen uptake (VO 2 ) test measuring heart rate (HR), VO 2 , ventilation (ventilatory equivalent [VE]/VO 2 ), and the Borg rating of perceived exertion (respiratory quotient [RQ]). Linear regression models were used to determine the associations between blood flow and maternal fitness measures.Results: Blood flows in the UTA (957 ± 241 mL/min) and UV (132 ± 38 mL/min/kg) were successfully measured in 20 (87%) participants. Neither was associated with any physical fitness parameters (HR, VO 2 , VE/VO 2 , and RQ) nor with any second-to-third trimester change in these parameters.Conclusion: PC-MRI can be used to noninvasively measure blood flow in the UTA and UV. Neither resting UTA nor UV flow is associated with maternal fitness parameters. This is the first MRI-based study to provide novel hemodynamic data suggesting decoupling between maternal moderate fitness level and the maternalplacental-fetal hemodynamic system in healthy, normal body mass index (BMI) pregnancies.List of Abbreviations: BMI, body mass index; ECG, electrocardiogram; GW, gestational weeks; HR, heart rate; MRI, magnetic resonance imaging; RPE, rate of perceived exertion; RQ, respiratory quotient; SD, standard deviation; SOGC, The Society of Obstetricians and Gynaecologists of Canada; UTA, uterine artery; UV, umbilical vein; VE, ventilatory equivalent; VO 2 , oxygen uptake; W, watts Dafna Sussman and Brahmdeep S. Saini contributed equally to the writing of this manuscript.

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Section: Discussionsupporting

confidence: 91%

Uterine artery and umbilical vein blood flow are unaffected by moderate habitual physical activity during pregnancy

et al. 2019

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“…Assertions about the amount of caffeine safe for consumption during pregnancy vary depending on the study referenced, and the FDA, taking into account for all the variations for this value has stated that any amount less than 300 mg per day is safe for pregnant women . In our study, we used a concentration of 0.25 mg mL −1 of caffeine, less than the FDA‐specified amount (300 mg per day = 0.67 mg mL −1 ), for perfusion analysis.…”

Section: Resultsmentioning

confidence: 99%

“…One study states that the half‐life of caffeine has a range of 6–16 h in pregnant women compared to that for non‐pregnant women, i.e., 2–8 h . According to guidelines provided by the WHO and FDA, the intake of caffeine during pregnancy should not exceed 300 mg per day, making it necessary to measure a pregnant woman's concentration of caffeine perfused into the fetus in relation to her total caffeine intake …”

Section: Introductionmentioning

confidence: 99%

Placenta‐on‐a‐Chip: In Vitro Study of Caffeine Transport across Placental Barrier Using Liquid Chromatography Mass Spectrometry

et al. 2019

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Due to the particular structure and functionality of the placenta, most current human placenta drug testing methods are limited to animal models, conventional cell testing, and cohort/controlled testing. Previous studies have produced inconsistent results due to physiological differences between humans and animals and limited availability of human and/or animal models for controlled testing. To overcome these challenges, a placenta‐on‐a‐chip system is developed for studying the exchange of substances to and from the placenta. Caffeine transport across the placental barrier is studied because caffeine is a xenobiotic widely consumed on a daily basis. Since a fetus does not carry the enzymes that inactivate caffeine, when it crosses a placental barrier, high caffeine intake may harm the fetus, so it is important to quantify the rate of caffeine transport across the placenta. In this study, a caffeine concentration of 0.25 mg mL −1 is introduced into the maternal channel, and the resulting changes are observed over a span of 7.5 h. A steady caffeine concentration of 0.1513 mg mL −1 is reached on the maternal side after 6.5 h, and a 0.0033 mg mL −1 concentration on the fetal side is achieved after 5 h.

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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%

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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Umbilical venous volume flow and fetal behavioral states in the normally developing fetus

Abstract: K E Y W O R D S:

Cited by 21 publications

References 21 publications

Uterine artery and umbilical vein blood flow are unaffected by moderate habitual physical activity during pregnancy

Uterine artery and umbilical vein blood flow are unaffected by moderate habitual physical activity during pregnancy

Placenta‐on‐a‐Chip: In Vitro Study of Caffeine Transport across Placental Barrier Using Liquid Chromatography Mass Spectrometry

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

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