Ventriculovascular physiology of the growth‐restricted fetus

Gardiner, Helena M.; Brodszki, Jana; Maršál, Karel

doi:10.1046/j.1469-0705.2001.00436.x

Cited by 54 publications

(48 citation statements)

References 40 publications

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“…31,32 It was further observed that reduction of somatic growth in IUGR was accompanied by a reduction in the peripheral vascular bed size. 31 However, after correction for estimated fetal weight, the fetal aortic vessel diameters were found to be comparable to those of the normally grown fetuses, thus indicating that the discrepancy between body habitus and vessel size observed in our study may possibly be a phenomenon occurring after birth.…”

Section: Discussionmentioning

confidence: 96%

Impaired Vascular Growth in Late Adolescence After Intrauterine Growth Restriction

et al. 2005

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Background-Abnormal blood flow in a fetus small for gestational age indicates true fetal intrauterine growth restriction (IUGR). We tested the hypothesis that IUGR with abnormal fetal blood flow is associated with long-term abnormal vascular morphology and function in adolescence. Methods and Results-In a prospective study, vascular mechanical properties of the common carotid artery (CCA), abdominal aorta , and popliteal artery (PA) were assessed by echo-tracking sonography in 21 adolescents with IUGR and abnormal fetal aortic blood flow and in 23 adolescents with normal fetal growth and normal fetal aortic blood flow. Endothelium-dependent and -independent vasodilatation of the brachial artery was measured by high-resolution ultrasound. After adjustment for body surface area and sex, the IUGR group had significantly smaller end-diastolic vessel diameters than the referents in the abdominal aorta and PA (mean difference, 1.7 mm [95% CI, 0.62 to 2.74] and 0.6 mm [95% CI, 0.25 to 1.02], respectively) (Pϭ0.003 and Pϭ0.002, respectively), with a similar trend in the CCA (Pϭ0.09). A higher resting heart rate was observed in the IUGR group (Pϭ0.01). No differences were found in stiffness or in endothelium-dependent and -independent vasodilatation between the 2 groups. Conclusions-IUGR caused by placental insufficiency appears to be associated with impaired vascular growth persisting into young adulthood in both men and women. The smaller aortic dimensions and the higher resting heart rate seen in adolescents with previous IUGR may be of importance for future cardiovascular health.

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Section: Discussionmentioning

confidence: 96%

Impaired Vascular Growth in Late Adolescence After Intrauterine Growth Restriction

et al. 2005

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“…They appear to have a lower pulsewave velocity, possibly caused by stiffer arteries with decreased vessel-wall pulsations. 7,35 The pulse-wave velocity correlates with mean blood pressure and is associated with the PSVs of the cardiac outflow tracts. 7 The present finding that cardiac output and PSV are reduced in fetuses with suboptimal fetal growth is consistent with decreased pulsewave velocity in small fetuses and suggests increased afterload with raised mean arterial pressure.…”

Section: Cardiac Circulationmentioning

confidence: 99%

Fetal Hemodynamic Adaptive Changes Related to Intrauterine Growth

Verburg¹,

Jaddoe²,

Wladimiroff³

et al. 2008

Circulation

136

131

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Background-It has been suggested that an adverse fetal environment increases susceptibility to hypertension and cardiovascular disease in adult life. This increased risk may result from suboptimal development of the heart and main arteries in utero and from adaptive cardiovascular changes in conditions of reduced fetal growth. The aim of the present study was to evaluate whether reduced fetal growth is associated with fetal circulatory changes and cardiac dysfunction. Methods and Results-This study was embedded in a population-based, prospective cohort study starting in early fetal life.Fetal growth characteristics and fetal circulation variables were assessed with ultrasound and Doppler examinations in 1215 healthy women. The fetal circulation was examined in relation to estimated fetal weight. Higher placental resistance indices were strongly associated with decreased fetal growth. Cerebral resistance showed a gradual decline with reduced fetal growth. Cardiac output, peak systolic velocity of the outflow tracts, and cardiac compliance showed a gradual reduction with diminished fetal growth, whereas intraventricular pressure gradually increased. Conclusions-Decreased

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“…The distinction between infants who have not achieved their growth potential and have shown abnormal Doppler waveforms-usually reduced, absent, or reversed flow in the descending aorta during fetal life intrauterine growth restriction (IUGR)-and those destined to be small with normal Doppler flow profiles (SGA) is vital because the vascular influences during fetal life are different. Not only do IUGR fetuses experience direct abnormalities of vascular impedance, altering their flow patterns for sustained periods, 5,6 but they are also often exposed to potential transgenerational influences. Pregnancy complications, such as low birth weight, preterm delivery, and preeclampsia, are associated with a 7-fold increased risk of the mother requiring hospitalization or dying from ischemic heart disease within the subsequent 2 decades.…”

Section: See Article By Olander Et Almentioning

confidence: 99%

A Womb With a View

Gardiner

2016

Circ: Cardiovascular Imaging

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Ventriculovascular physiology of the growth‐restricted fetus

Cited by 54 publications

References 40 publications

Impaired Vascular Growth in Late Adolescence After Intrauterine Growth Restriction

Impaired Vascular Growth in Late Adolescence After Intrauterine Growth Restriction

Fetal Hemodynamic Adaptive Changes Related to Intrauterine Growth

A Womb With a View

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