scholarly journals OP10.10: Time interval analysis of flow velocity waveforms of ductus venosus in fetal growth restriction in correlation with pH of umbilical artery

2019 ◽  
Vol 54 (S1) ◽  
pp. 118-119
Author(s):  
N. Seo ◽  
D. Tachibana ◽  
Y. Kurihara ◽  
N.W. Yokoi ◽  
T. Suekane ◽  
...  
Keyword(s):  
Flow Velocity ◽  
Fetal Growth ◽  
Interval Analysis ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Time Interval

scholarly journals Time interval analysis of ductus venosus and cardiac cycles in relation with umbilical artery pH at birth in fetal growth restriction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomoki Suekane ◽  
Daisuke Tachibana ◽  
Yasushi Kurihara ◽  
Natsuko Yokoi ◽  
Naomi Seo ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Interval Analysis ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Time Interval ◽  
Z Score ◽  
Time Intervals ◽  
Z Scores

Abstract Background The aims of this study were to evaluate the time intervals of flow velocity waveforms (FVW) of ductus venosus (DV) and cardiac cycles, as well as the pulsatility index of DV-FVW (DV-PI), in correlation with umbilical artery (UA) pH at birth in fetal growth restriction (FGR) complicated with placental insufficiency. Methods Data were retrospectively retrieved from pregnancies complicated by FGR. FGR was defined as an estimated fetal weight below − 2.0 S.D. with an elevated UA-PI. Time interval assessments of DV-FVW were as follows: the duration of systolic wave was divided by the duration of diastolic wave and defined as DV-S/D. We also measured the following time intervals of ventricular inflow through tricuspid valve (TV) and mitral valve (MV): (iii), from the second peak of ventricular inflow caused by atrial contraction (A-wave) to the opening of atrio-ventricular valves and: (iv), from the opening of atrio-ventricular valves to the peak of A-wave. (iii)/(iv) was expressed as TV-S/D and MV-S/D, for TV and MV, respectively. The time interval data were transformed into z-scores. Results Thirty-one FGR fetuses were included in this study. Both DV-PI and DV-S/D showed significant correlation with UA-pH (r = − 0.677, p = < 0.001 and r = 0.489, p = 0.005 for DV-PI and z-score of DV-S/D, respectively) and more significances were observed in FGR ≤ 28 + 6 gestational weeks (r = − 0.819, p < 0.001 and r = 0.726, p = 0.005, for DV-PI and z-score of DV-S/D, respectively) than in FGR > 28 + 6 gestational weeks (r = − 0.634, p = 0.007 and r = 0.635, p = 0.020, for DV-PI and z-score of DV-S/D, respectively). On the other hand, TV-S/D and MV-S/D showed no significant correlation with UA-pH, although these z-scores indicated significant decreases compared with normal references. Conclusions Time interval analysis of DV-FVW might be a valuable parameter, as well as DV-PI, for the antenatal prediction of fetal acidemia in the management of FGR fetuses.

scholarly journals Задержка (замедление) роста плода: современные принципы диагностики, классификации и динамического наблюдения

2019 ◽  
pp. 33-44
Keyword(s):  
Doppler Ultrasound ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Cerebroplacental Ratio

В статье детально представлены унифицированные критерии диагностики задержки (замедления) роста плода, выработанные в 2016 г. ведущими мировыми экспертами и рекомендованные к применению в клинической и научной работе. Обсуждается современный подход к анализу допплерометрических параметров кровотока в системе “мать-плацентаплод”, включая расчет церебральноплацентар ного отношения. Приводятся международные принципы обследования беременных с задержкой роста плода, протоколы и алгоритмы дальнейшего наблюдения, выбора срока и метода родоразрешения, разработанные на основании доказательных многоцентровых европейских исследований. Ключевые слова: задержка (замедление) роста плода, церебрально-плацентарное отношение, артерия пуповины, маточная артерия, венозный проток, плацентарная недостаточность, ультразвуковое допплеровское исследование, fetal growth restriction, cerebroplacental ratio, umbilical artery, uterine artery, ductus venosus, placental insufficiency, Doppler ultrasound

scholarly journals Defining the relationship between fetal Doppler indices, abdominal circumference and growth rate in severe fetal growth restriction using functional linear discriminant analysis

2013 ◽  
Vol 10 (88) ◽  
pp. 20130376 ◽  
Author(s):  
Alon Talmor ◽  
Anneleen Daemen ◽  
Edile Murdoch ◽  
Hannah Missfelder-Lobos ◽  
Dirk Timmerman ◽  
...  
Keyword(s):  
Growth Rate ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Pulsatility Index ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Abdominal Circumference ◽  
Ductus Venosus ◽  
Linear Discriminant ◽  
The Relationship

The relationship between Doppler measurements, size and growth rate in fetal growth restriction has not been defined. We used functional linear discriminant analysis (FLDA) to investigate these parameters taking account of the difficulties inherent in exploring relationships between repeated observations from a small number of cases. In 40 fetuses with severe growth restriction, serial abdominal circumference (AC), umbilical, middle cerebral artery (MCA) and ductus venosus Doppler pulsatility index measurements were recorded. In 11 singleton fetuses with normal growth, umbilical artery pulsatility index only was measured. Data were expressed as z -scores in relation to gestation and analysed longitudinally using FLDA. In severe growth restriction, the Spearman correlation coefficients between umbilical artery pulsatility index and AC z -score, MCA pulsatility index and AC z -score and ductus venosus pulsatility index z -score and AC z -score were, respectively: −0.36, p = 4.4 × 10 −7 ; 0.70, p = 1.1 × 10 −17 and −0.50, p = 8.1 × 10 −4 . No relationship was seen between Doppler parameters and growth rate. There was no relationship between umbilical artery pulsatility index and AC nor growth rate in normally grown fetuses. In severe fetal growth restriction, Doppler changes are related to absolute fetal AC size, not growth rate.

scholarly journals Successful amnioinfusion for severe fetal growth restriction with umbilical cord complications: two case reports

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Daisuke Katsura ◽  
Yuichiro Takahashi ◽  
Shigenori Iwagaki ◽  
Rika Chiaki ◽  
Kazuhiko Asai ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Umbilical Cord ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Cord Compression ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Fetal Ultrasound ◽  
Fetal Doppler

Abstract Background There is no established treatment for fetal growth restriction during pregnancy. We report two cases that represent an example of an amnioinfusion-based management strategy for severe fetal growth restriction with umbilical cord complications. Case presentation We encountered two cases of fetal growth restriction with abnormal fetal Doppler velocity. In one case, fetal ultrasound revealed a hypercoiled umbilical cord with a single umbilical artery and oligohydramnios, while fetal Doppler revealed a reversed end-diastolic flow in the umbilical artery and reversed a-waves of the ductus venosus. Umbilical cord compression was confirmed at 22 weeks and 2 days of gestation, and nine amnioinfusions were performed to relieve the umbilical cord compression. A cesarean section was performed at 31 weeks and 2 days of gestation because of severe preeclampsia. The Asian infant is now a normally developed 6-month-old. In another Asian case, fetal ultrasound revealed a hypercoiled cord, while fetal Doppler revealed a reversed end-diastolic flow in the umbilical artery and intermittent reversed a-waves of the ductus venosus. Umbilical cord compression was confirmed at 24 weeks and 5 days of gestation, and seven amnioinfusions were performed. A cesarean section was performed at 31 weeks and 1 day of gestation because of nonreassuring fetal status. At the age of 1 month, the Asian infant was stable on respiratory circulation. In both cases, fetal Doppler findings improved significantly following amnioinfusions. Conclusions Amnioinfusion is a symptomatic treatment for umbilical cord compression. However, to determine the therapeutic effect of amnioinfusion, complete resolution of the umbilical cord compression should be ascertained by ultrasonography.

scholarly journals The role of sildenafil citrate in the treatment of fetal growth restriction: a randomized controlled trial

2019 ◽  
Vol 8 (5) ◽  
pp. 1840
Author(s):  
Ahmed Abdelshafy ◽  
Khaled Ibrahim Abdullah ◽  
Sherif Ashoush ◽  
Heba E. Hosni
Keyword(s):  
Middle Cerebral Artery ◽  
Fetal Growth ◽  
Cerebral Artery ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Controlled Trial ◽  
Maternity Hospital ◽  
Growth Restriction ◽  
Sildenafil Citrate ◽  
Doppler Velocity

Background: This study was aimed to evaluate the effect of sildenafil citrate on Doppler velocity indices in patients with fetal growth restriction (FGR) associated with impaired placental circulation.Methods: A double-blinded, parallel group randomized clinical trial (clinicaltrials.gov NCT02590536) was conducted in Ain Shams Maternity Hospital, in the period between October 2015 and June 2017. Ninety pregnant women with documented intrauterine growth retardation at 24-37 weeks of gestation were randomized to either sildenafil citrate 25 mg orally every 8 hours or placebo visually-identical placebo tablets with the same regimen. The primary outcome of the study was the change in umbilical artery and fetal middle cerebral artery indices.Results: There was a significant improvement in umbilical and middle cerebral artery indices after sildenafil administration p<0.001. Present study observed that, sildenafil group, in comparison to placebo, has a significantly higher mean neonatal birth weight. 1783±241g vs 1570±455g (p<0.001). There was a significantly higher mean gestational age at delivery in women in sildenafil group 35.3±1.67 weeks, whereas it was lower in the placebo group 33.5±1.7 weeks. The side effects as headache, palpitation and facial flushing were significantly higher in sildenafil group compared to placebo group.Conclusions: The use sildenafil citrate in pregnancies with fetal growth restriction (FGR) improved the feto-placental Doppler indices (pulsatility index of umbilical artery and middle cerebral artery) and improved neonatal outcomes.

Umbilical artery extracellular matrix remodeling in fetal growth restriction

2004 ◽  
Vol 191 (6) ◽  
pp. S10
Author(s):  
Wendy Kinzler ◽  
John Smulian ◽  
C. Andrew Kistler ◽  
Rita Hahn ◽  
Peihong Zhou ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Extracellular Matrix Remodeling ◽  
Matrix Remodeling
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