Clinical significance of umbilical artery intermittent vs persistent absent end-diastolic velocity in growth-restricted fetuses

Bligard, Katherine H.; Xu, Xinyuan; Raghuraman, Nandini; Dicke, Jeffrey M.; Odibo, Anthony O.; Frolova, Antonina I.

doi:10.1016/j.ajog.2022.06.005

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…In our study, some predictors of adverse perinatal outcomes, including chronic hypertension, 13–18 PIH history, 16,17 PIH, 13,14 and early‐onset FGR, 13–15 and all three simple ultrasound parameters (i.e., EFW < 5th percentile, 19 AFI <5 cm, 15 and abnormal UA Doppler 13,14,16,18–21 ) were consistent with those in previous reports. With regard to PIH history, chronic hypertension, and current pregnancy PIH, the results were expected because these factors were associated with maternal vascular diseases, leading to adverse effects on fetal growth and well‐being due to placental insufficiency.…”

Section: Discussionsupporting

confidence: 91%

“…In our study, some predictors of adverse perinatal outcomes, including chronic hypertension, [13][14][15][16][17][18] PIH history, 16,17 PIH, 13,14 and early-onset FGR, [13][14][15] and all three simple ultrasound parameters (i.e., EFW < 5th percentile, 19 AFI <5 cm, 15 and abnormal UA Doppler 13,14,16,[18][19][20][21] ) were consistent with those in previous reports.…”

Section: Discussionsupporting

confidence: 90%

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Predictors of adverse perinatal outcomes in fetal growth restriction using a combination of maternal clinical factors and simple ultrasound parameters

Punyapet

Suwanrath

Chainarong

et al. 2023

Intl J Gynecology & Obste

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Fetal growth restriction (FGR) is a common obstetric complication that affects approximately 10% of pregnancies worldwide, with higher incidence in underdeveloped or developing countries. 1 Growth-restricted fetuses are at risk of perinatal morbidity, mortality, and poor long-term outcomes such as neurodevelopmental delay in childhood or cardiovascular and endocrine diseases in adulthood. [2][3][4][5][6][7][8][9] Several definitions of FGR have been proposed by national and international societies. For example, the American College of

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Predictors of adverse perinatal outcomes in fetal growth restriction using a combination of maternal clinical factors and simple ultrasound parameters

Punyapet

Suwanrath

Chainarong

et al. 2023

Intl J Gynecology & Obste

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show abstract

“…Evidence supporting this view includes the observation that suboptimal fetal growth is associated with increased risk for unexpected fetal death 8 . Growth-restricted fetuses with absent or reversed end-diastolic blood flow in the umbilical arteries on Doppler ultrasonography are at particular risk for death 9,10 . These Doppler findings are indicative of increased downstream vascular impedance to blood flow secondary to reduced perfusion of the uteroplacental unit.…”

Section: Introductionmentioning

confidence: 99%

Evolutionary perspective of uteroplacental malperfusion: subjacent insult common to most pregnancy complications

Espinoza

2023

Ultrasound in Obstet & Gyne

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“…Outcomes are substantially worse in the severe, early-onset phenotype of FGR, defined by an estimated fetal weight or abdominal circumference less than the third percentile or abnormal umbilical artery Doppler velocities diagnosed before 32 weeks [5][6][7]. When Doppler abnormalities have progressed to absent or reversed umbilical artery velocities, there is high risk for perinatal death [8][9][10][11]. Among survivors, there remains substantial risk for adverse early and long-term outcomes [12,13].…”

Section: Introductionmentioning

confidence: 99%

Angiogenic Function of Human Placental Endothelial Cells in Severe Fetal Growth Restriction Is Not Rescued by Individual Extracellular Matrix Proteins

Sayres,

Flockton,

et al. 2023

Cells

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Severe fetal growth restriction (FGR) is characterized by increased placental vascular resistance resulting from aberrant angiogenesis. Interactions between endothelial cells (ECs) and the extracellular matrix (ECM) are critical to the complex process of angiogenesis. We have previously found that placental stromal abnormalities contribute to impaired angiogenesis in severe FGR. The objective of this research is to better characterize the effect of individual ECM proteins on placental angiogenic properties in the setting of severe FGR. ECs were isolated from human placentae, either control or affected by severe FGR, and subjected to a series of experiments to interrogate the role of ECM proteins on adhesion, proliferation, migration, and apoptosis. We found impaired proliferation and migration of growth-restricted ECs. Although individual substrates did not substantially impact migratory capacity, collagens I, III, and IV partially mitigated proliferative defects seen in FGR ECs. Differences in adhesion and apoptosis between control and FGR ECs were not evident. Our findings demonstrate that placental angiogenic defects that characterize severe FGR cannot be explained by a singular ECM protein, but rather, the placental stroma as a whole. Further investigation of the effects of stromal composition, architecture, stiffness, growth factor sequestration, and capacity for remodeling is essential to better understand the role of ECM in impaired angiogenesis in severe FGR.

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Clinical significance of umbilical artery intermittent vs persistent absent end-diastolic velocity in growth-restricted fetuses

Cited by 3 publications

References 18 publications

Predictors of adverse perinatal outcomes in fetal growth restriction using a combination of maternal clinical factors and simple ultrasound parameters

Predictors of adverse perinatal outcomes in fetal growth restriction using a combination of maternal clinical factors and simple ultrasound parameters

Evolutionary perspective of uteroplacental malperfusion: subjacent insult common to most pregnancy complications

Angiogenic Function of Human Placental Endothelial Cells in Severe Fetal Growth Restriction Is Not Rescued by Individual Extracellular Matrix Proteins

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