Magnetic resonance assessment of the effect of maternal position on fetoplacental blood flow and oxygenation

Couper, Sophie; Clark, Alys R.; Mirjalili, Ali; Flouri, Dimitra; Aughwane, Rosalind; David, Anna L.; Melbourne, Andrew; Stone, Peter

doi:10.1016/j.placenta.2019.06.268

Cited by 2 publications

(3 citation statements)

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“… 58 Moreover, DECIDE identified that compared with the left lateral position, maternal supine position in healthy late pregnancy is associated with reduced uteroplacental blood flow and oxygen transfer across the placenta. There was an average 6.2% reduction in oxygen delivery to the fetus and an average 11% reduction in fetal umbilical venous blood flow 59 . This may be a possible mechanism behind the known association between supine sleeping and late pregnancy stillbirth.…”

Section: Clinical Assessment Of the Fetus And The Placentamentioning

confidence: 89%

“…There was an average 6.2% reduction in oxygen delivery to the fetus and an average 11% reduction in fetal umbilical venous blood flow. 59 This may be a possible mechanism behind the known association between supine sleeping and late pregnancy stillbirth. The findings demonstrate the huge potential that this computational MRI technology holds for the future understanding of placental function, an important consideration when testing drugs in pregnancy.…”

Section: S70mentioning

confidence: 99%

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Clinical Assessment of Fetal Well‐Being and Fetal Safety Indicators

David

Spencer

2022

The Journal of Clinical Pharma

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Delivering safe clinical trials of novel therapeutics is central to enable pregnant women and their babies to access medicines for better outcomes. This review describes clinical monitoring of fetal well-being and safety. Current pregnancy surveillance includes regular antenatal checks of blood pressure and urine for signs of gestational hypertension. Fetal and placental development is assessed routinely using the first-trimester "dating" and mid-trimester "anomaly" ultrasound scans, but the detection of fetal anomalies can continue throughout pregnancy using targeted sonography or magnetic resonance imaging (MRI). Serial sonography can be used to assess fetal size, well-being, and placental function. Carefully defined reproducible imaging parameters, such as the head circumference (HC), abdominal circumference (AC), and femur length (FL), are combined to calculate an estimate of the fetal weight. Doppler analysis of maternal uterine blood flow predicts placental insufficiency, which is associated with poor fetal growth. Fetal doppler analysis can indicate circulatory decompensation and fetal hypoxia, requiring delivery to be expedited. Novel ways to assess fetal well-being and placental function using MRI, computerized cardiotocography (CTG), serum circulating fetoplacental proteins, and mRNA may improve the assessment of the safety and efficacy of maternal and fetal interventions. Progress has been made in how to define and grade clinical trial safety in pregnant women, the fetus, and neonate. A new system for improved safety monitoring for clinical trials in pregnancy, Maternal and Fetal Adverse Event Terminology (MFAET), describes 12 maternal and 18 fetal adverse event (AE) definitions and severity grading criteria developed through an international modified Delphi consensus process. This fills a vital gap in maternal and fetal translational medicine research.

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Section: Clinical Assessment Of the Fetus And The Placentamentioning

confidence: 89%

Section: S70mentioning

confidence: 99%

Clinical Assessment of Fetal Well‐Being and Fetal Safety Indicators

David

Spencer

2022

The Journal of Clinical Pharma

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“…This approach has been used in FGR 92 and to analyses the effect of maternal position on placental function. 151 Attempts have also been made to carry out this separation using ultrasound. 152 Current interest in uterine contractions and the effect on placental function suggests that the combination of information from dynamic BOLD MRI could be combined with markers of volume or shape change in the placenta.…”

Section: Looking Forward: Mixed Models and Computational Modellingmentioning

confidence: 99%

Developments in functional imaging of the placenta

Clark

Flouri

Mufti

et al. 2022

BJR

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The placenta is both the literal and metaphorical black box of pregnancy. Measurement of the function of the placenta has the potential to enhance our understanding of this enigmatic organ and serve to support obstetric decision making. Advanced imaging techniques are key to supporting these measurements. This review summarises emerging imaging technology being used to measure the function of the placenta and new developments in the computational analysis of this data. We address three important examples where functional imaging is supporting our understanding of these conditions: fetal growth restriction, placenta accreta, and twin-twin transfusion syndrome.

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Magnetic resonance assessment of the effect of maternal position on fetoplacental blood flow and oxygenation

Cited by 2 publications

References 0 publications

Clinical Assessment of Fetal Well‐Being and Fetal Safety Indicators

Clinical Assessment of Fetal Well‐Being and Fetal Safety Indicators

Developments in functional imaging of the placenta

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