Natriuretic peptide levels in intrauterine growth-restricted fetuses with absent and reversed end-diastolic flow of the umbilical artery in relation to ductus venosus flow velocities

2011 ◽  
Vol 39 (5) ◽  
Author(s):  
Franz Bahlmann ◽  
Frank Krummenauer ◽  
Stephan Spahn ◽  
Ralph Gallinat ◽  
Christoph Kampmann
Keyword(s):  
Natriuretic Peptide ◽  
Umbilical Artery ◽  
Ductus Venosus ◽  
Intrauterine Growth ◽  
Diastolic Flow ◽  
Flow Velocities

Placenta Share Discordance and Umbilical Artery Doppler Change After Antenatal Betamethasone Administration in Monochorionic Twins With Selective Intrauterine Growth Restriction: Is There a Link?

2012 ◽  
Vol 15 (5) ◽  
pp. 680-684 ◽  
Author(s):  
Yao-Lung Chang ◽  
Shuenn-Dyh Chang ◽  
An-Shine Chao ◽  
Peter C. C. Hsieh ◽  
Chao-Nin Wang ◽  
...  
Keyword(s):  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Placental Weight ◽  
Monochorionic Twins ◽  
Monochorionic Twin ◽  
Intrauterine Growth ◽  
Diastolic Flow ◽  
Umbilical Artery Doppler ◽  
Estimated Fetal Weight

This study was designed to evaluate the degree of placenta share discordance in relation to the betamethasone-induced return of positive end-diastolic flow in monochorionic twin pregnancies with selective intrauterine growth restriction (sIUGR) and abnormal umbilical artery Doppler. Monochorionic twins with sIUGR was defined as one twin having an estimated fetal weight below the 10th percentile combined with an estimated fetal weight discordance >25%. The umbilical artery Doppler directly prior to (D0) and 24 hours (D1) and 48 hours (D2) after the first dose of betamethasone administration was recorded. The estimated individual placental weight in monochorionic twins was obtained by cutting the placenta along the vascular equator into two territories; the placenta share discordance was calculated as [(estimated individual placental weight of appropriated for gestational age twin- estimated individual placental weight of growth restricted twin)/estimated individual placental weight of appropriated for gestational age twin] × 100%. Six (23.1%) of the 26 included cases achieved betamethasone-induced return of positive umbilical artery end-diastolic flow. The difference of placenta share discordance and birth weight discordance were not significantly different between twins with and without betamethasone-induced return of positive umbilical artery end-diastolic flow. Thus, according to our study results, it was proposed that although the placenta share discordance correlated with the abnormal umbilical artery Doppler in the IUGR fetus in monochorionic twin, the betamethasone-induced return of positive umbilical artery end-diastolic flow, however, did not reveal the similar relationship with the severity of placenta share discordance.

Cord Occlusion in Monochorionic Twins with Early Selective Intrauterine Growth Restriction and Abnormal Umbilical Artery Doppler: A Consecutive Series of 90 Cases

2015 ◽  
Vol 39 (3) ◽  
pp. 186-191 ◽  
Author(s):  
Mauro Parra-Cordero ◽  
Mar Bennasar ◽  
José María Martínez ◽  
Elisenda Eixarch ◽  
Ximena Torres ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Consecutive Series ◽  
Type Ii ◽  
Monochorionic Twins ◽  
Intrauterine Growth ◽  
Umbilical Artery Doppler

Objective: To describe perinatal outcomes achieved with cord occlusion (CO) in monochorionic twins with severe selective intrauterine growth restriction (sIUGR) and abnormal umbilical artery Doppler in the IUGR twin (types II and III). Methods: We studied a consecutive series of 90 cases of sIUGR with abnormal Doppler treated with CO of the IUGR fetus. Abnormal Doppler was defined as continuous (type II, n = 41) or intermittent (type III, n = 49) absent/reversed end-diastolic flow. All cases presented at least one of the following severity criteria: gestational age (GA) <22 weeks, inter-twin estimated weight discordance >35%, reversed end-diastolic umbilical artery flow or ductus venosus pulsatility index >95th centile. We prospectively recorded pregnancy course and perinatal outcome. Results: Median GA at surgery was 20.6 weeks and mean duration 22.4 min. Miscarriage (<24 weeks) occurred in 3.3% (3/90) and preterm delivery <32 weeks in 7.1% (6/84) of continuing pregnancies. GA at delivery was 36.4 weeks and neonatal survival of the larger twin was achieved in 93.3%. Conclusion: In a consecutive series studied by an experienced team, CO in monochorionic twins with severe sIUGR type II or III was associated with delivery >32 weeks in 92.9% and neonatal survival of the normal twin in 93.3% of pregnancies.

Hematological changes in severe early onset growth-restricted fetuses with absent and reversed end-diastolic flow in the umbilical artery

2017 ◽  
Vol 45 (3) ◽  
Author(s):  
Franz Bahlmann ◽  
Ammar Al Naimi ◽  
Manfred Ossendorf ◽  
Monica Schmidt-Fittschen ◽  
Arne Willruth
Keyword(s):  
Early Onset ◽  
Umbilical Artery ◽  
Reverse Flow ◽  
Color Doppler ◽  
Venous Blood ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Diastolic Flow ◽  
Hemodynamic Compromise ◽  
Hematological Changes

AbstractBackground:Erythropoietin seems to play an important role in the regulation of fetal hypoxemia. The present prospective study was designed to determine if changes in erythropoietin levels can be found in fetuses with severe early-onset growth restriction and hemodynamic compromise.Methods and results:Erythropoietin, hemoglobin, hematocrit, platelet counts, normoblasts, lacate, arterial and venous blood gasses in the umbilical cord were determined in 42 fetuses with fetal growth restriction (IUGR) with absent (zero-flow) and 26 IUGR fetuses with retrograde end-diastolic flow (reverse-flow) in the umbilical artery. Color Doppler measurements were performed on the middle cerebral artery (PI) and ductus venosus [(S-a)/D and (S-a)/VConclusions:Fetuses with severe IUGR due to chronic placental insufficiency and absent or reversed flow in the umbilical artery show increased erythropoietin levels.

Effect of antenatal betamethasone administration on Doppler velocimetry of fetal and uteroplacental vessels: a prospective study

2016 ◽  
Vol 44 (2) ◽  
Author(s):  
Atalay Ekin ◽  
Cenk Gezer ◽  
Ulas Solmaz ◽  
Cuneyt Eftal Taner ◽  
Mehmet Ozeren ◽  
...  
Keyword(s):  
Doppler Ultrasonography ◽  
Umbilical Artery ◽  
Ductus Venosus ◽  
Fetal Blood ◽  
Reversed Flow ◽  
Uterine Arteries ◽  
Diastolic Flow ◽  
A Prospective Study ◽  
Intensive Surveillance ◽  
Singleton Pregnancies

AbstractTo examine the effect of antenatal betamethasone administration on Doppler parameters of fetal and uteroplacental circulation.Seventy-six singleton pregnancies that received betamethasone therapy were prospectively evaluated. Doppler measurements of pulsatility indices (PI) in fetal umbilical artery (UA), middle cerebral artery (MCA), ductus venosus and maternal uterine arteries were performed before (0 h) and 24, 48, 72 and 96 h after the first dose of betamethasone. Women with positive end-diastolic flow (EDF) in UA and those with absent or reversed EDF in UA were evaluated separately.Fifty-two women with EDF in UA and 24 women with absent or reversed flow in UA were examined. Administration of maternal betamethasone was followed by a significant decrease in the PI of the MCA at 24 h (P<0.05). Additionally, return of absent to positive, reversed to absent or from reversed to positive diastolic flow in UA was detected within 24 h in 19 (79.2%) fetuses with absent or reversed UA-EDF. All alterations were transient and maintained up to 72 h.Antenatal administration of betamethasone is associated with significant but transient changes in the fetal blood flow. Hence, intensive surveillance of fetuses with Doppler ultrasonography is warranted following betamethasone therapy.

Placenta morphology and absent or reversed end diastolic flow velocities in the umbilical artery: a clinical and morphometrical study

Placenta ◽  
1996 ◽  
Vol 17 (7) ◽  
pp. 393-399 ◽  
Author(s):  
V.H.M. Karsdorp ◽  
B.K. Dirks ◽  
J.C. van der Linden ◽  
J.M.G. van Vugt ◽  
J.P.A. Baak ◽  
...  
Keyword(s):  
Umbilical Artery ◽  
Diastolic Flow ◽  
Morphometrical Study ◽  
Flow Velocities
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