Mathematical modelling of the human foetal cardiovascular system based on Doppler ultrasound data

Pennati, Giancarlo; Bellotti, M.; Fumero, R.

doi:10.1016/s1350-4533(97)84634-6

Cited by 77 publications

(78 citation statements)

References 37 publications

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“…For simulations, the resistance of normal placental territories downstream of each umbilical artery is assumed to be RN ϭ 4,325 ϫ 10 5 N ⅐ s ⅐ m Ϫ5 (0.053 mmHg ⅐ ml Ϫ1 ⅐ min), where the subscript N stands for "normal" (15). For fetal blood at body temperature, we used ϭ 1,060 kg ⅐ m 3 and ϭ 0.004 kg ⅐ m Ϫ1 ⅐ s Ϫ1 (7,23).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Hemodynamic analysis of Hyrtl anastomosis in human placenta

Gordon¹,

Eytan²,

Jaffa³

et al. 2007

American Journal of Physiology-Regulatory, Integrative and Comp

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The Hyrtl anastomosis is a common connection between the umbilical arteries near the cord insertion in most human placentas. It has been speculated that it equalizes the blood pressure between the territories supplied by the umbilical arteries. However, its functional role in the regulation and distribution of fetal blood flow to the placenta has not yet been explored. A computational model has been developed for quantitative analysis of hemodynamic characteristic of the Hyrtl anastomosis in cases of discordant blood flow in the umbilical arteries. Simulations were performed for cases of either increased placental resistance at the downstream end or reduced arterial blood flow due to some pathologies upstream of one of the arteries. The results indicate that when placental territories of one artery impose increased resistance to fetal blood flow, the Hyrtl anastomosis redistributes the blood flow into the second artery to reduce the large pressure gradients that are developed in the affected artery. When one of the arteries conducts a smaller blood flow into the placenta and a relatively smaller pressure gradient is developed, the Hyrtl anastomosis rebuilds the pressure gradients in the affected artery and redistributes blood flow from the unaffected artery to the affected one to improve placental perfusion. In conclusion, the Hyrtl anastomosis plays the role of either a safety valve or a pressure stabilizer between the umbilical arteries at the placental insertion.

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Section: Methodsmentioning

confidence: 99%

“…1B), we assumed that the normal inlet pressure is P inlet-N ϭ 5,150 Pa (38.6 mmHg), similar to the data of Weiner et al (29). The outlet of the model is assumed to be at the level of fetal capillaries within the cotyledons; hence, P outlet ϭ 1,200 Pa (9 mmHg) (14,15).…”

Section: Methodsmentioning

confidence: 99%

Hemodynamic analysis of Hyrtl anastomosis in human placenta

Gordon¹,

Eytan²,

Jaffa³

et al. 2007

American Journal of Physiology-Regulatory, Integrative and Comp

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“…Numerical values for most model parameters were obtained directly from the scientific literature (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Numerical values for a few parameters that are specific to our model needed to be derived (Supplemental Methods, Supplemental Digital Content, http://links.lww.com/PDR/A57).…”

Section: Methodsmentioning

confidence: 99%

A Model for Educational Simulation of Hemodynamic Transitions at Birth

et al. 2010

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Birth is characterized by swift and complex transitions in hemodynamic and respiratory variables. Unrecognized pathologies or incidents may quickly become fatal or cause permanent damage. This article introduces an essential component of an acute perinatal care simulator, namely a model for educational simulation of normal hemodynamic transitions seen during and shortly after birth. We explicitly formulate educational objectives and adapt a preexisting model for the simulation of neonatal cardiovascular physiology to include essential aspects of fetal hemodynamics. From the scientific literature, we obtain model parameters that characterize these aspects quantitatively. The fetal model is controlled by a time-and event-based script of changes occurring at birth, such as onset of breathing and cord clamping, and the transitory phase up to 24 h after birth. Comparison of simulation results with published target data confirms that realistic simulated hemodynamic vital signs are achieved. (Pediatr Res 67: 158-165, 2010) P erinatal acute care is associated with specific clinical demands and challenges. The relatively small number of acute care cases occurring in many institutions, together with the presence of senior staff assuming the responsibility for their management, may hinder the establishment of adequate training for less experienced individuals. In other areas of acute care medicine, realistic simulators contribute to training of healthcare professionals and to patient safety.Clinically relevant learning objectives for medical staff in Neonatology include the recognition of cardiovascular signs and symptoms occurring in pathologies that manifest shortly after birth, such as persistent pulmonary hypertension, left ventricular overload by a patent ductus arteriosus (DA), myocardial depression, and hemorrhage.This article introduces a fundamental component of a perinatal acute care simulator, namely a simulation engine, for normal hemodynamic transitions from the fetal to the early neonatal period. A simulation engine can contribute to a life-like training environment by providing real-time, automatic evolution of clinical signs and monitored signals and of their response to therapeutic interventions. To be able to simulate normal physiology and provide a platform for future simulation of the above-mentioned incidents and pathologies, it is necessary that the engine reflect essential aspects of fetal hemodynamics and its subsequent transition to the neonate. Among others, structures such as lungs, placenta, heart, systemic arterial circulation, and the various fetal shunts need to be included. The simulation engine should be able to simulate realistic blood pressures and flow rates in these structures during fetal, transitional, and neonatal periods. METHODSThe proposed simulation engine for normal hemodynamic transitions from the fetal to the early neonatal period consists of a fetal hemodynamic model controlled by a time-and event-based script (1). The script triggers events occurring at birth such ...

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“…Modern advancement in Doppler ultrasonography has facilitated the usage of highresolution ultrasound imaging, equipped with a coaxial pulsed wave for monitoring of the fetal circulation and the investigation of blood velocity waveforms both in normal and pathological circumstances [4][5][6]. Presently umbilical artery blood flow velocity waveform analysis is used for the evaluation of feto-placental blood flow.…”

Section: Introductionmentioning

confidence: 99%

Simulation and Analysis of Umbilical Blood Flow using Markov-based Mathematical Model

Queyam¹,

Pahuja²,

Singh³

2017

IJISA

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Abstract-The intra-uterine development of the fetus depends on various factors, one such critical factor is umbilical blood flow because the quantity of oxygen delivered to the placenta and to the fetus is directly limited by umbilical blood flow rate. Since the measurement of the hemodynamic quantities such as blood pressure and blood flow rate is not possible in utero hence the use of patient-specific mathematical modeling is beneficial for the assessment of feto-maternal wellbeing. A Markov model based mathematical model of fetal circulation is developed by taking three node concept. The fetus, the umbilical cord, and the placenta represent the 3 nodes of Markov model. A LabVIEWbased virtual instrument is designed to simulate the mathematical model which results in waveform similar to Doppler blood flow velocimetry of umbilical artery. The model is simulated at various degree of conductivity of the umbilical cord to the oxygenated blood. Simulation results show that the umbilical artery blood flow velocity waveform depends on gestation age, fetal heart rate, uterine contraction and placental insufficiency. The Doppler indices calculated from simulation helps in predicting both fetal and maternal abnormalities at various degrees of the conductivity to the blood flow passage. Therefore, integrating patient-specific models along with established medical equipments will be helpful in identifying true intra-uterine growth restricted fetuses from normal fetuses and helps clinicians to take timely interventions.

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Mathematical modelling of the human foetal cardiovascular system based on Doppler ultrasound data

Cited by 77 publications

References 37 publications

Hemodynamic analysis of Hyrtl anastomosis in human placenta

Hemodynamic analysis of Hyrtl anastomosis in human placenta

A Model for Educational Simulation of Hemodynamic Transitions at Birth

Simulation and Analysis of Umbilical Blood Flow using Markov-based Mathematical Model

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