A mechanical sector and linear array real-time scanner combined with a pulsed Doppler system was used for recording the flow velocity waveform in the internal carotid artery, the lower thoracic part of the descending aorta and umbilical artery in the human fetus. A total of 42 fetuses in normal pregnancy and nine growth-retarded fetuses between 26 and 41 weeks gestation was studied. In normal pregnancy the mean pulsatility index (PI) in the internal carotid artery varied between 1-5 and 1.6, in the descending aorta between 1.7 and 1-8 and in the umbilical artery between 0.7 and 1.3. In the growth-retarded fetuses the PI was reduced in the internal carotid artery and raised in the descending aorta and umbilical artery, suggesting an increased peripheral vascular resistance in the fetal body and placenta and a compensatory reduction in peripheral vascular resistance in the fetal cerebrum, i.e. a brain-sparing effect in the presence of fetal hypoxia. SUPPI 1, 60-69. 50-57.
A mechanical sector and linear array real-time scanner combined with a pulsed Doppler system was used for recording the flow velocity waveform in the internal carotid artery, the lower thoracic part of the descending aorta and umbilical artery in the human fetus. A total of 42 fetuses in normal pregnancy and nine growth-retarded fetuses between 26 and 41 weeks gestation was studied. In normal pregnancy the mean pulsatility index (PI) in the internal carotid artery varied between 1-5 and 1.6, in the descending aorta between 1.7 and 1-8 and in the umbilical artery between 0.7 and 1.3. In the growth-retarded fetuses the PI was reduced in the internal carotid artery and raised in the descending aorta and umbilical artery, suggesting an increased peripheral vascular resistance in the fetal body and placenta and a compensatory reduction in peripheral vascular resistance in the fetal cerebrum, i.e. a brain-sparing effect in the presence of fetal hypoxia. SUPPI 1, 60-69. 50-57.
suMMARY Thirty fetuses with cardiac arrythmias were referred for ultrasonography. This included cross sectional and M mode echocardiography and pulsed Doppler analysis of the fetal heart. Three types of arrhythmias were observed: ectopic beats, tachyarrhythmias, and bradycardia. Ectopic beats were associated with cardiac structural abnormalities in two cases, resulting in fetal death in one. Tachycardia was not associated with structural defect, but death from cardiac failure occurred in one patient. Transplacental treatment for tachyarrhythmia was not successful in our experience. In the group with bradycardia four cases had congenital cardiac abnormalities and the mortality rate was 50%.When a fetal cardiac arrhythmia has been established careful structural and rhythm analysis is of vital importance in facilitating prognosis, planning of time and mode of delivery, and monitoring of transplacental treatment where indicated.
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