Central arterial hemodynamics in small‐for‐gestational‐age fetuses before and during maternal hyperoxygenation: a Doppler velocimetric study with particular attention to the aortic isthmus

Brantberg, A.; Sonesson, Sven Erik

doi:10.1046/j.1469-0705.1999.14040237.x

Cited by 20 publications

(17 citation statements)

References 31 publications

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“…An increase in middle cerebral artery peak systolic velocity can subsequently be detected (14). Brain-sparing can also be identified by absence or reversal of end-diastolic flow in the aortic isthmus (15). A feature of advanced blood flow redistribution is the ability to visualize coronary blood flow on Doppler sonography, indicating maximal redistribution to the fetal heart ("heart-sparing") (11).…”

Section: Prenatal Circulatory Adaptationsmentioning

confidence: 99%

“…In late-onset IUGR (beyond 30 wk gestational age), the umbilical artery indices usually remain within normal limits (16). Doppler abnormalities are frequently limited to signs of brainsparing such as an abnormal pulsatility index of the middle cerebral artery and absent or reversed end-diastolic flow in the aortic isthmus (15,16).…”

Section: Prenatal Circulatory Adaptationsmentioning

confidence: 99%

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Intrauterine growth restriction: impact on cardiovascular development and function throughout infancy

et al. 2016

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Intrauterine growth restriction (IUGR) refers to the situation where a fetus does not grow according to its genetic growth potential. One of the main causes of IUGR is uteroplacental vascular insufficiency. Under these circumstances of chronic oxygen and nutrient deprivation, the growth-restricted fetus often displays typical circulatory changes, which in part represent adaptations to the suboptimal intrauterine environment. These fetal adaptations aim to preserve oxygen and nutrient supply to vital organs such as the brain, the heart, and the adrenals. These prenatal circulatory adaptations are thought to lead to an altered development of the cardiovascular system and "program" the fetus for life long cardiovascular morbidities. In this review, we discuss the alterations to cardiovascular structure, function, and control that have been observed in growth-restricted fetuses, neonates, and infants following uteroplacental vascular insufficiency. We also discuss the current knowledge on early life surveillance and interventions to prevent progression into chronic disease. Intrauterine growth restriction (IUGR) refers to the situation where a fetus does not grow according to its genetic growth potential. The main cause of IUGR in developed countries is uteroplacental vascular insufficiency (1), which drives the fetus to redistribute its cardiac output to preserve oxygen and nutrient supply to the brain, heart, and adrenals. Although these adaptive circulatory changes are beneficial during intrauterine life, they are thought to cause dysfunctional development of the cardiovascular system and "program" the fetus for life long cardiovascular morbidities (2). This is also known as the Developmental Origins of Health and Disease hypothesis, which postulates that insults during intrauterine and early postnatal development can permanently change the body's structure, function, and metabolism and influence susceptibility to adult noncommunicable diseases (2). Despite their increased risk of cardiovascular disease, infants born growth restricted usually do not receive long-term cardiovascular follow-up. Depending on the definition used, IUGR can occur in up to 10% of pregnancies, and as cardiovascular disease is the number one cause of death worldwide (3), early identification of cardiovascular risk factors and targeted interventions in this high-risk population are of major clinical importance. In this review, we discuss the alterations of cardiovascular structure, function, and control that have been observed in infants born growth restricted and their implications for surveillance and intervention to prevent progression into chronic disease. CHALLENGES IN IDENTIFYING IUGRThe current literature uses many different definitions of IUGR, which may explain some of the contradicting findings discussed in this review. Traditionally, and most commonly, IUGR is defined as a birth weight below the 10th percentile for gestational age on the normative population growth curve (4). This definition, however, merely describes those who ...

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Section: Prenatal Circulatory Adaptationsmentioning

confidence: 99%

Section: Prenatal Circulatory Adaptationsmentioning

confidence: 99%

Intrauterine growth restriction: impact on cardiovascular development and function throughout infancy

et al. 2016

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“…The observation of fetal AAS with a small, thin, underfilled LV, ultimately manifesting as a completely normal LV after birth, has led us to investigate the possibility of recreating this phenomenon before birth. Maternal hyperoxygenation in the third trimester of pregnancy has been applied in a number of conditions, both from a diagnostic and therapeutic perspective. It can promote fetal pulmonary vasodilation, thereby influencing the quantity of pulmonary venous return to the left side of the heart.…”

Section: Introductionmentioning

confidence: 99%

Maternal hyperoxygenation improves left heart filling in fetuses with atrial septal aneurysm causing impediment to left ventricular inflow

Channing

Szwast

Natarajan

et al. 2015

Ultrasound Obstet Gynecol

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“…Despite these accepted uses for maternal hyperoxygenation, it has been suggested that maternal oxygen therapy may be associated with increased fetal cerebral vascular resistance, based on sheep 6,7 and human fetal 8,9 data. The cause for increased cerebral resistance with hyperoxygenation may be concurrent hypocapnia, which is known to cause systemic arterial as well as cerebral vascular constriction 10 .…”

Section: Introductionmentioning

confidence: 99%

Effects of maternal hyperoxia with and without normocapnia in uteroplacental and fetal Doppler studies

Simchen

Tesler

Azami

et al. 2005

Ultrasound in Obstet & Gyne

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Central arterial hemodynamics in small‐for‐gestational‐age fetuses before and during maternal hyperoxygenation: a Doppler velocimetric study with particular attention to the aortic isthmus

Cited by 20 publications

References 31 publications

Intrauterine growth restriction: impact on cardiovascular development and function throughout infancy

Intrauterine growth restriction: impact on cardiovascular development and function throughout infancy

Maternal hyperoxygenation improves left heart filling in fetuses with atrial septal aneurysm causing impediment to left ventricular inflow

Effects of maternal hyperoxia with and without normocapnia in uteroplacental and fetal Doppler studies

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