Reference ranges for umbilical vein blood flow in the second half of pregnancy based on longitudinal data

Acharya, Ganesh; Wilsgaard, Tom; Berntsen, Gro; Maltau, Jan Martin; Kiserud, Torvid

doi:10.1002/pd.1091

Cited by 93 publications

(109 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An increasing umbilical venous blood flow throughout gestation was found previously (13)(14)(15)(16)30,31). We found a similar development (Fig.…”

Section: Discussionsupporting

confidence: 75%

“…However, three recent publications showed excellent agreement between both methods for flow calculation in the UV (14,22) and the PV (18), which is reassuring for the method applied in this study. The data presented in this study confirm the flow estimates of some recent studies (14,15,22,31), but somehow lower than others (13,16,30,33) possibly because of sampling site, insonation technique, and diameter measurements as discussed previously (14). Our results are partly different to those of Bellotti et al (16) also in regard to the flow distribution between the left and right liver lobes.…”

Section: Discussionmentioning

confidence: 81%

“…Although single components of the venous liver circulation such as umbilical blood flow (12)(13)(14) and shunting through the ductus venosus (DV) (15,16) have been investigated earlier, little is known about the distributions of umbilical and portal blood flows in the human fetus.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Longitudinal Study of Umbilical and Portal Venous Blood flow to the Fetal Liver: Low Pregnancy Weight Gain is Associated With Preferential Supply to the Fetal Left Liver Lobe

et al. 2008

Self Cite

View full text Add to dashboard Cite

Recent data suggest that umbilical venous perfusion of the fetal liver has an important influence on fetal growth and postnatal liver function, and that maternal factors in late pregnancy modify this circulation. In a longitudinal study of 160 low-risk pregnancies, we determined how umbilical and portal venous blood flows to the fetal liver changed during gestation, and examined the hypothesis that maternal body mass index and pregnancy weight gain influenced fetal liver blood flows. We measured blood flows in the umbilical and portal veins, left portal branch, and ductus venosus using ultrasound. Normalizing for estimated fetal weight, fetal liver total venous blood flow fell from 84 to 57 mL ⅐ min Ϫ1 ⅐ kg Ϫ1 during 21-39 wk of gestation; toward term the portal contribution increased (from 14 to 20%) and the umbilical contribution fell, whereas distribution between the left and right liver lobes was stable, 60%/ 40%. Greater flow of nutrient-rich umbilical venous blood to the liver was associated with higher birth weight and neonatal ponderal index. Maternal body mass index was not related to fetal liver blood flows, but low pregnancy weight gain strongly influenced flow distribution between the right and left liver lobes, sparing the left lobe and increasing the difference between lobes by 16%. T he developmental origins of health and disease hypothesis established a link between an adverse intrauterine environment and cardiovascular disease in adult life (1,2). There is strong evidence from epidemiologic studies and animal experiments that an adverse intrauterine environment is associated with raised levels of cardiovascular risk factors controlled by the liver (3). The role of the fetal liver for intrauterine growth and development has therefore come into focus of research.In fetal sheep, experimental reduction in umbilical venous liver perfusion results in decreased synthesis of insulin-like growth factors by the fetal liver, decreasing the cellular proliferation rate in peripheral tissues and impairing fetal growth (4,5). In human fetuses, venous liver blood flow was shown to be modulated by maternal diet and body composition (6).The fetal liver receives venous blood from the umbilical and portal veins (PVs). The umbilical vein (UV) directs nutrient-rich placental blood predominantly to the left liver lobe, whereas nutrient-depleted blood from the PV is directed to the right liver lobe (7). This selective perfusion pattern is thought to be the main reason for differences in micro architecture (8), hematopoiesis (9) and gene and enzyme expression (10,11).Although single components of the venous liver circulation such as umbilical blood flow (12-14) and shunting through the ductus venosus (DV) (15,16) have been investigated earlier, little is known about the distributions of umbilical and portal blood flows in the human fetus.The aim of the present study was to study simultaneously the umbilical and portal venous circulations and the blood flow distribution to the liver lobes in the second half of ...

show abstract

“…An increasing umbilical venous blood flow throughout gestation was found previously (13)(14)(15)(16)30,31). We found a similar development (Fig.…”

Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 81%

See 1 more Smart Citation

Longitudinal Study of Umbilical and Portal Venous Blood flow to the Fetal Liver: Low Pregnancy Weight Gain is Associated With Preferential Supply to the Fetal Left Liver Lobe

et al. 2008

Self Cite

View full text Add to dashboard Cite

show abstract

“…Barbera et al [34] found that reduced umbilical venous flow was due to reduced velocity and not to a reduced diameter of the umbilical vein. Latest investigations therefore focus again on volume fiow in the umbilical vein [20,35,36].…”

Section: Umbilical Vein (Uv)mentioning

confidence: 99%

Doppler sonography of the fetal venous circulation

Hofstaetter

Schiermeier

Arabin

2005

The Ultrasound Review of Obstetrics & Gynecology

View full text Add to dashboard Cite

Venous Dnppler sonography has been used for assessment of the fetal hemodynamics in the last 15 years. The velocimetries of the central fetal veins -umhilical vein (UV), ductus venosus (DV), hepatic veins (HV) and inferior vena cava (IVC) -reflect the cardiac functioti and its impairment due to changes in cardiac preload or afterload, and due to changes in the cardiac rhythm. It is possible to see the severity of the disturbance in cardiac function and venous Doppler is broadly used in the surveillance of pregnancies,, which are disturbed by severe placental insufficiency, cardiac defects, arrhythmias, anemia, hydrops fetalis and hyper-or hypovolemia as in tu-in-to-twin transfusion syndrome. Herein we summarize the past, present and eventual future developments of venous Doppler sonography, reflecting the physiology and pathophysiology of the fetal venous circulation and describing the state of the art of its clinical application.

show abstract

“…The mass was located near the cord insertion site (3.5 cm). Morphologic fetal examination revealed no structural malformations, but did show signs suggesting hemodynamic overload, such as cardiomegaly (cardiothoracic area ratio 41%) [6] together with an umbilical vein diameter 1 97.5 percentile (6.1 mm) [7] . Doppler study did not show tricuspid insuffi ciency, the pulsatility index in the ductus venosus was in the normal range (0.7) [8] and the peak systolic velocity in the MCA was 0.40 m/s, also within normal limits for gestational age [5] .…”

Section: Case Reportmentioning

confidence: 99%

Prenatal Management of Placental Chorioangioma: Value of the Middle Cerebral Artery Peak Systolic Velocity

et al. 2006

View full text Add to dashboard Cite

Placental chorioangiomas are benign tumors of the placenta. Large chorioangiomas may cause severe complications such as fetal anemia, hydrops and fetal death. We report the use of sonographic findings and peak systolic velocity in the middle cerebral artery in the diagnosis and management of fetal anemia without the occurrence of hydrops fetalis in a pregnant woman with a large placental chorioangioma. Successful intrauterine blood transfusion was performed at 26 weeks. Spontaneous thrombosis of the main supplying blood vessel of the chorioangioma was detected at 33 weeks. The child was delivered at 39 weeks of pregnancy in normal clinical condition.

show abstract

Reference ranges for umbilical vein blood flow in the second half of pregnancy based on longitudinal data

Abstract: New reference ranges for UV blood flow based on longitudinal observations appear slightly different from cross-sectional studies, and should be more appropriate for serial evaluation of fetal circulation.

Cited by 93 publications

References 36 publications

Longitudinal Study of Umbilical and Portal Venous Blood flow to the Fetal Liver: Low Pregnancy Weight Gain is Associated With Preferential Supply to the Fetal Left Liver Lobe

Longitudinal Study of Umbilical and Portal Venous Blood flow to the Fetal Liver: Low Pregnancy Weight Gain is Associated With Preferential Supply to the Fetal Left Liver Lobe

Doppler sonography of the fetal venous circulation

Prenatal Management of Placental Chorioangioma: Value of the Middle Cerebral Artery Peak Systolic Velocity

Contact Info

Product

Resources

About