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Fetal ductus venosus, middle cerebral artery and umbilical artery flow responses to uterine contractions in growth-restricted human pregnancies.

Fu, Jing LU and Olofsson, Per LU (2007) In Ultrasound in Obstetrics & Gynecology 30(6). p.867-873
Abstract
Objective To explore fetal ductus venosus (DV) flow velocity changes relative to umbilical artery (UA) blood flow and brain-sparing flow (BSF) during uterine contractions.



Methods Forty-five term fetuses suspected of having growth restriction were exposed to an oxytocin challenge test (OCT) with simultaneous Doppler velocimetry in the UA, middle cerebral artery (MCA) and DV. Basal BSF was defined as a MCA-to-UA pulsatility index (PI) ratio of < 1.08, and de novo BSF as a decrease in MCA-PI of >= 1 SD (equivalent to a value of 0.24 units) during the OCT.



Results Basal DV flow velocities were lower in the BSF group (n = 7) than they were in the non-BSF group (n = 3 8). During the OCT, D V flow... (More)
Objective To explore fetal ductus venosus (DV) flow velocity changes relative to umbilical artery (UA) blood flow and brain-sparing flow (BSF) during uterine contractions.



Methods Forty-five term fetuses suspected of having growth restriction were exposed to an oxytocin challenge test (OCT) with simultaneous Doppler velocimetry in the UA, middle cerebral artery (MCA) and DV. Basal BSF was defined as a MCA-to-UA pulsatility index (PI) ratio of < 1.08, and de novo BSF as a decrease in MCA-PI of >= 1 SD (equivalent to a value of 0.24 units) during the OCT.



Results Basal DV flow velocities were lower in the BSF group (n = 7) than they were in the non-BSF group (n = 3 8). During the OCT, D V flow velocity parameters changed in neither group but MCA-PI decreased in the non-BSF group. A crude de novo BSF was not associated with DV flow velocity changes, but when UA-PI changes were considered, a serial relationship was found between decreased UA-PI, increased DV flow velocity, and decreased MCA-PI When UA-PI increased, the MCA-PI still decreased (though not significantly) but DV flow velocity parameters remained unchanged.



Conclusions Established fetal BSF is associated with low DV flow velocities, but in an acute sequence there might be two contrasting courses along which BSF develops: one with an increase and one with a decrease in the UA vascular flow resistance. In the former situation the DV flow velocity increases, while in the latter situation the role of the DV in the acute redistribution of fetal blood flow is unclear. Copyright (c) 2007 ISUOG. Published by John Wiley & Sons, Ltd. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Ultrasound in Obstetrics & Gynecology
volume
30
issue
6
pages
867 - 873
publisher
John Wiley & Sons
external identifiers
  • wos:000251742800013
  • scopus:36749072724
ISSN
1469-0705
DOI
10.1002/uog.4048
language
English
LU publication?
yes
id
80a1cd44-ea6d-4ebb-802f-35985f1cea57 (old id 608599)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17935265&dopt=Abstract
date added to LUP
2009-07-09 09:31:17
date last changed
2017-01-01 06:45:45
@article{80a1cd44-ea6d-4ebb-802f-35985f1cea57,
  abstract     = {Objective To explore fetal ductus venosus (DV) flow velocity changes relative to umbilical artery (UA) blood flow and brain-sparing flow (BSF) during uterine contractions.<br/><br>
<br/><br>
Methods Forty-five term fetuses suspected of having growth restriction were exposed to an oxytocin challenge test (OCT) with simultaneous Doppler velocimetry in the UA, middle cerebral artery (MCA) and DV. Basal BSF was defined as a MCA-to-UA pulsatility index (PI) ratio of &lt; 1.08, and de novo BSF as a decrease in MCA-PI of &gt;= 1 SD (equivalent to a value of 0.24 units) during the OCT.<br/><br>
<br/><br>
Results Basal DV flow velocities were lower in the BSF group (n = 7) than they were in the non-BSF group (n = 3 8). During the OCT, D V flow velocity parameters changed in neither group but MCA-PI decreased in the non-BSF group. A crude de novo BSF was not associated with DV flow velocity changes, but when UA-PI changes were considered, a serial relationship was found between decreased UA-PI, increased DV flow velocity, and decreased MCA-PI When UA-PI increased, the MCA-PI still decreased (though not significantly) but DV flow velocity parameters remained unchanged.<br/><br>
<br/><br>
Conclusions Established fetal BSF is associated with low DV flow velocities, but in an acute sequence there might be two contrasting courses along which BSF develops: one with an increase and one with a decrease in the UA vascular flow resistance. In the former situation the DV flow velocity increases, while in the latter situation the role of the DV in the acute redistribution of fetal blood flow is unclear. Copyright (c) 2007 ISUOG. Published by John Wiley &amp; Sons, Ltd.},
  author       = {Fu, Jing and Olofsson, Per},
  issn         = {1469-0705},
  language     = {eng},
  number       = {6},
  pages        = {867--873},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Fetal ductus venosus, middle cerebral artery and umbilical artery flow responses to uterine contractions in growth-restricted human pregnancies.},
  url          = {http://dx.doi.org/10.1002/uog.4048},
  volume       = {30},
  year         = {2007},
}