scholarly journals Infant outcome after active management of early‐onset fetal growth restriction with absent or reverse umbilical artery blood flow

2020 ◽  
Author(s):  
E. Morsing ◽  
J. Brodszki ◽  
A. Thuring ◽  
K. Maršál
Keyword(s):  
Blood Flow ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Early Onset ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Active Management ◽  
Artery Blood Flow ◽  
Infant Outcome

scholarly journals Sildenafil citrate therapy in absent end diastolic flow in umbilical artery in an early onset fetal growth restriction (FGR) fetus

2018 ◽  
Vol 7 (12) ◽  
pp. 5173
Author(s):  
Rana A. Choudhary ◽  
Khyati Patrawala ◽  
Kavita Desai ◽  
Kedar Ganla
Keyword(s):  
Blood Flow ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Early Onset ◽  
Umbilical Artery ◽  
Fetal Outcome ◽  
Growth Restriction ◽  
Sildenafil Citrate ◽  
Optimal Time ◽  
Diastolic Flow

Fetal growth restriction (FGR), a pregnancy complication still poses as a challenge for obstetricians worldwide. This is because of its association with severe morbidity and mortality outcomes. Obstetrical management becomes a dilemma in determining the optimal time of delivery and weighing the risks of prematurity against the risks of a potentially hostile intrauterine environment. There may be placental insufficiency characterized by insufficient blood flow in the umbilical artery. This is termed as abnormal umbilical artery flow with absent or reversed end diastolic flow on Doppler USG. Worsening of this condition demands an earlier delivery of the fetus. Authors report a case of structurally normal foetus showing severe early onset FGR with absent end diastolic flow in umbilical artery on Doppler, which was managed using vaginal Sildenafil citrate. Sildenafil citrate led to improvement in uterine artery and umbilical artery Doppler parameters; thereby improving the utero-placental blood flow with a favorable fetal outcome at delivery. The gestation was prolonged by 51 days. Thus, Sildenafil citrate can be used as promising agent in early onset FGR in selected cases.

Melatonin supplementation alters uteroplacental hemodynamics and fetal development in an ovine model of intrauterine growth restriction

2012 ◽  
Vol 302 (4) ◽  
pp. R454-R467 ◽  
Author(s):  
Caleb O. Lemley ◽  
Allison M. Meyer ◽  
Leticia E. Camacho ◽  
Tammi L. Neville ◽  
David J. Newman ◽  
...  
Keyword(s):  
Blood Flow ◽  
Fetal Growth ◽  
Intrauterine Growth Restriction ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Artery Blood Flow ◽  
Ovine Model ◽  
Melatonin Treatment ◽  
Intrauterine Growth

Using a mid- to late-gestation ovine model of intrauterine growth restriction (IUGR), we examined uteroplacental blood flow and fetal growth during melatonin supplementation as a 2 × 2 factorial design. At day 50 of gestation, 32 ewes were supplemented with 5 mg of melatonin (MEL) or no melatonin (CON) and were allocated to receive 100% [adequate; (ADQ)] or 60% [restricted (RES)] of nutrient requirements until day 130 of gestation. Umbilical artery blood flow was increased from day 60 to day 110 of gestation in MEL vs. CON dams, while umbilical artery blood flow was decreased from day 80 to day 110 of gestation in RES vs. ADQ dams. At day 130 of gestation, uteroplacental hemodynamics, measured under general anesthesia, and fetal growth were evaluated. Uterine artery blood flow was decreased in RES vs. ADQ dams, while melatonin supplementation did not affect uterine artery blood flow. Total placentome weight and placentome number were not different between treatment groups. Fetal weight was decreased by nutrient restriction. Abdominal girth and ponderal index were increased in fetuses from MEL-ADQ dams vs. all other groups. Fetal biparietal distance was decreased in CON-RES vs. CON-ADQ dams, while melatonin supplementation rescued fetal biparietal distance. Fetal kidney length and width were increased by maternal melatonin treatment. Fetal cardiomyocyte area was altered by both maternal melatonin treatment and nutritional plane. In summary, melatonin may negate the consequences of IUGR during specific abnormalities in umbilical blood flow as long as sufficient uterine blood perfusion is maintained during pregnancy.

sFlt ‐1/ PlGF ratio and timing of delivery in early‐onset fetal growth restriction with antegrade umbilical artery flow

2020 ◽  
Vol 56 (4) ◽  
pp. 549-556 ◽  
Author(s):  
M. S. Quezada ◽  
J. Rodríguez‐Calvo ◽  
C. Villalaín ◽  
P. I. Gómez‐Arriaga ◽  
A. Galindo ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Early Onset ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Artery Flow ◽  
Plgf Ratio

scholarly journals 502 Progression rate of umbilical artery doppler indices in severe early-onset fetal growth restriction

2021 ◽  
Vol 224 (2) ◽  
pp. S317
Author(s):  
Juliana Gevaerd Martins ◽  
Phillip Connell ◽  
Lindsay Gould ◽  
Carole Barake ◽  
Tetsuya Kawakita ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Early Onset ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Progression Rate ◽  
Umbilical Artery Doppler ◽  
Doppler Indices

scholarly journals Correlation between Parturients’ Uterine Artery Blood Flow Spectra in the First and Second Trimesters of Pregnancy and Fetal Growth Restriction

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hongna Yu ◽  
Meiqin Yuan ◽  
Ling Wang ◽  
Xia Li ◽  
Meiping Jiang
Keyword(s):  
Blood Flow ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Uterine Artery ◽  
First Trimester ◽  
Growth Restriction ◽  
Control Group ◽  
Artery Blood Flow ◽  
Second Trimester ◽  
Total Incidence

Objective. To explore the correlation between parturients’ uterine artery blood flow spectra in the first and second trimesters of pregnancy and fetal growth restriction (FGR). Methods. The data of parturients treated in our hospital from February 2018 to February 2020 were retrospectively analyzed, 50 parturients with FGR were selected as the FGR group, and other 50 healthy cases were selected as the control group. In the first trimester (11-12 weeks of gestation) and the second trimester of pregnancy (13–24 weeks of gestation), the parturients of the two groups accepted the color Doppler ultrasonography (CDS), their hemodynamics indicators of uterine artery were recorded, and the correlation between their uterine artery blood flow spectra in the two periods and FGR was analyzed with the Receiver Operating Characteristic (ROC) curve. Results. No statistical differences in the parturients’ general information including age, gestational weeks, gravidity, and parity between the two groups were observed ( P  > 0.05); the newborn’s body weight, Apgar scores, number of preterm infants, and the number of infants transferring to the neonatal intensive care unit (NICU) were significantly different between the two groups ( P  < 0.05); in the first and second trimesters of pregnancy, the uterine artery pulsatility index (UtA-PI), uterine artery resistance index (UtA-RI), maximal systolic flow velocity, and systolic/diastolic (UtA-S/D) ratio were significantly higher in the FGR group than in the control group ( P  < 0.05), and the time-averaged maximal velocity (TAMX) was significantly lower in the FGR group than in the control group ( P  < 0.001); in early pregnancy, the incidence of early diastolic notch at bilateral uterine arteries between the two groups was not significantly different ( P  > 0.05), and the unilateral and total incidence in the first trimester as well as the unilateral, bilateral, and total incidence in the second trimester were significantly higher in the FGR group than in the control group ( P  < 0.05); in the first trimester, the sensitivity of detecting FGR with a uterine artery blood flow spectrum was 0.820, AUC (95% CI) = 0.840 (0.757–0.923), and in the second trimester, it was 0.860, AUC (95% CI) = 0.900 (0.832–0.968). Conclusion. There is a correlation between uterine artery blood flow spectra in the first and second trimesters of pregnancy and FGR, and the sensitivity of spectrum in the first trimester is higher than that in the second trimester, presenting a better clinical application value.

scholarly journals Increased uterine artery blood flow in hypoxic murine pregnancy is not sufficient to prevent fetal growth restriction†

2019 ◽  
Vol 102 (3) ◽  
pp. 660-670 ◽  
Author(s):  
Sydney L Lane ◽  
Alexandrea S Doyle ◽  
Elise S Bales ◽  
Ramón A Lorca ◽  
Colleen G Julian ◽  
...  
Keyword(s):  
Blood Flow ◽  
Fetal Growth ◽  
Murine Model ◽  
Pregnancy Complications ◽  
Fetal Growth Restriction ◽  
Uterine Artery ◽  
Growth Restriction ◽  
Late Gestation ◽  
Artery Blood Flow ◽  
Uterine Arteries

Abstract Incomplete maternal vascular responses to pregnancy contribute to pregnancy complications including intrauterine growth restriction (IUGR) and preeclampsia. We aimed to characterize maternal vascular dysfunction in a murine model of fetal growth restriction as an approach toward identifying targetable pathways for improving pregnancy outcomes. We utilized a murine model of late-gestation hypoxia-induced IUGR that reduced E18.5 fetal weight by 34%. Contrary to our hypothesis, uterine artery blood flow as measured in vivo by Doppler ultrasound was increased in mice housed under hypobaric hypoxia (385 mmHg; 5500 m) vs normoxia (760 mmHg; 0 m). Using wire myography, uterine arteries isolated from hypoxic mice had similar vasodilator responses to the two activators A769662 and acetylcholine as those from normoxic mice, although the contribution of an increase in nitric oxide production to uterine artery vasodilation was reduced in the hypoxic vs normoxic groups. Vasoconstrictor responses to phenylephrine and potassium chloride were unaltered by hypoxia. The levels of activated adenosine monophosphate-activated protein kinase (AMPK) were reduced with hypoxia in both the uterine artery and placenta as measured by western blot and immunohistochemistry. We concluded that the rise in uterine artery blood flow may be compensatory to hypoxia but was not sufficient to prevent fetal growth restriction. Although AMPK signaling was reduced by hypoxia, AMPK was still receptive to pharmacologic activation in the uterine arteries in which it was a potent vasodilator. Thus, AMPK activation may represent a new therapy for pregnancy complications involving reduced uteroplacental perfusion.

scholarly journals AMP‐activated protein kinase activator AICAR attenuates hypoxia‐induced murine fetal growth restriction in part by improving uterine artery blood flow

2020 ◽  
Vol 598 (18) ◽  
pp. 4093-4105
Author(s):  
Sydney L. Lane ◽  
Julie A. Houck ◽  
Alexandrea S. Doyle ◽  
Elise S. Bales ◽  
Ramón A. Lorca ◽  
...  
Keyword(s):  
Blood Flow ◽  
Protein Kinase ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Uterine Artery ◽  
Growth Restriction ◽  
Artery Blood Flow ◽  
Amp Activated Protein Kinase
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