Placental ischemia and changes in umbilical and uteroplacental arterial and venous hemodynamics

Thuring, Ann; Maršál, Karel; Laurini, Ricardo

doi:10.3109/14767058.2011.594466

Cited by 6 publications

(3 citation statements)

References 25 publications

(27 reference statements)

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“…Membrane rupture can cause vessel rupture with a risk of exsanguination and foetal demise. Flow compression can translate into placental infarcts and limb amputations [21][22][23][24][25]. In addition, the risks of low birth weight and perinatal death are increased [20,26].…”

Section: Other Vascular Disordersmentioning

confidence: 99%

Considering the Effects and Maternofoetal Implications of Vascular Disorders and the Umbilical Cord

et al. 2022

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The umbilical cord is a critical anatomical structure connecting the placenta with the foetus, fulfilling multiple functions during pregnancy and hence influencing foetal development, programming and survival. Histologically, the umbilical cord is composed of three blood vessels: two arteries and one vein, integrated in a mucous connective tissue (Wharton’s jelly) upholstered by a layer of amniotic coating. Vascular alterations in the umbilical cord or damage in this tissue because of other vascular disorders during pregnancy are worryingly related with detrimental maternofoetal consequences. In the present work, we will describe the main vascular alterations presented in the umbilical cord, both in the arteries (Single umbilical artery, hypoplastic umbilical artery or aneurysms in umbilical arteries) and the vein (Vascular thrombosis, aneurysms or varicose veins in the umbilical vein), together with other possible complications (Velamentous insertion, vasa praevia, hypercoiled or hypocoiled cord, angiomyxoma and haematomas). Likewise, the effect of the main obstetric vascular disorders like hypertensive disorders of pregnancy (specially pre-eclampsia) and chronic venous disease on the umbilical cord will also be summarized herein.

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Section: Other Vascular Disordersmentioning

confidence: 99%

Considering the Effects and Maternofoetal Implications of Vascular Disorders and the Umbilical Cord

et al. 2022

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“…Creating a weighted summary score of chronic and acute pre-and perinatal risk factors allows for ischemia-hypoxia exposure severity to be measured on a continuum (Getahun et al 2013;Lewis and Murray 1987). In addition, directly measuring maternal-placental-fetal blood flow with Doppler ultrasound may provide a more direct measure of prenatal ischemia (Guvendag et al 2013;Thuring et al 2012) at the time of assessment. Further, placental pathology examination may provide researchers a physiological measure of limited placental-fetal blood and oxygen flow, which have previously been linked to autism (Walker et al 2013).…”

Section: Summary and Research Considerationsmentioning

confidence: 99%

Pre- and Perinatal Ischemia-Hypoxia, the Ischemia-Hypoxia Response Pathway, and ADHD Risk

et al. 2016

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This review focuses on how measured pre- and perinatal environmental and (epi)genetic risk factors are interrelated and potentially influence one, of many, common developmental pathway towards ADHD. Consistent with the Developmental Origins of Health and Disease hypothesis, lower birth weight is associated with increased ADHD risk. Prenatal ischemia-hypoxia (insufficient blood and oxygen supply in utero) is a primary pathway to lower birth weight and produces neurodevelopmental risk for ADHD. To promote tissue survival in the context of ischemia-hypoxia, ischemia-hypoxia response (IHR) pathway gene expression is altered in the developing brain and peripheral tissues. Although altered IHR gene expression is adaptive in the context of ischemia-hypoxia, lasting IHR epigenetic modifications may lead to increased ADHD risk. Taken together, IHR genetic vulnerability to ischemia-hypoxia and IHR epigenetic alterations following prenatal ischemia-hypoxia may result in neurodevelopmental vulnerability for ADHD. Limitations of the extant literature and future directions for genetically-informed research are discussed.

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“…It is known that defective placentation results in raised uterine artery impedance [5]. Abnormal uterine artery flow pattern was shown to be related with high ischemic score and placental infarctions [6]. High resistant uterine artery Doppler measures in the first trimester are clearly associated with impaired endovascular trophoblastic invasion and increased risk of adverse pregnancy outcomes secondary to placental dysfunction [7].…”

Section: Introductionmentioning

confidence: 99%

Gebeliğin birinci trimesterinde sistemik inflamatuar belirteçler ile yüksek uterin arter pulsatilite indeksi ilişkisi

UYGUR

2023

Family Practice and Palliative Care

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Introduction: Preeclampsia is a serious complication of pregnancy leading to maternal and perinatal morbidity and mortality. The etiopathogenesis still remains unsolved, however, various theories currently become well-proved. The leading etiopathogenetic mechanisms are impaired placentation, and placental hypoxia, immune mechanisms, systemic inflammatory reaction, endothelial damage and maternal cardiovascular maladaptation. These mechanisms overlap and induce each other. There are some preventive interventions only if the patients at high-risk are identified timely. This study aimed to investigate the relationship between the inflammatory pathway and placental insufficiency in the first trimester, utilizing the clinical markers of both. It also aims to find out a cheap and easy test to identify those who absolutely need to undergo a comprehensive risk assessment. Methods: This retrospective observational study included 28 patients with high uterine artery resistance (pulsatility index >90th centile) in the first trimester as study group and 67 patients with normal uterine artery resistance in the first trimester as control group. The two groups were compared in terms of risk factors for preeclampsia. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio as systemic inflammatory markers were compared between the groups. ROC analysis was performed to obtain a cut-off value for predicting high uterine artery pulsatility index. Results: Demographic data, anamnestic and examination risk factors for preeclampsia did not differ between the groups. However, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were significantly higher in the patients with uterine artery pulsatility index above 90th centile. A cut off value of 3.58 and 136.9 of Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio, respectively were determined for predicting first trimester uterine artery pulsatility index above 90th centile. Conclusions: Neutrophil/lymphocyte and platelet/lymphocyte ratio can simply be used to identify the patients who need referral for uterine artery doppler assessment. Keywords: preeclampsia, uterine artery, pulsatil flow, neutrophil, lymphocyte, placenta

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Placental ischemia and changes in umbilical and uteroplacental arterial and venous hemodynamics

Cited by 6 publications

References 25 publications

Considering the Effects and Maternofoetal Implications of Vascular Disorders and the Umbilical Cord

Considering the Effects and Maternofoetal Implications of Vascular Disorders and the Umbilical Cord

Pre- and Perinatal Ischemia-Hypoxia, the Ischemia-Hypoxia Response Pathway, and ADHD Risk

Gebeliğin birinci trimesterinde sistemik inflamatuar belirteçler ile yüksek uterin arter pulsatilite indeksi ilişkisi

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