Spectral Doppler Sonography: Waveform Analysis and Hemodynamic Interpretation

Maulik, Dev

doi:10.1007/3-540-28903-8_4

Cited by 13 publications

(11 citation statements)

References 42 publications

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“…It is known that the faster the heart rate, the lower the ejection fraction and peak systolic velocity. 52 In the group of rats with PE induced by l-NAME, one surprising finding is the decrease in the uterine artery PI on days E8 and E11 ( Table 2). Apart from the abovementioned haemodynamic differences between humans and rats, the interpretation of this concept is quite complex.…”

Section: Discussionmentioning

confidence: 93%

Sildenafil citrate improves perinatal outcome in fetuses from pre‐eclamptic rats

Herraiz

Pellicer

Serra

et al. 2012

BJOG

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Objective To evaluate perinatal outcome after sildenafil citrate (SC) administration at the onset of pregnancy in a rat preeclampsia model.Design In vivo animal experimental study.Setting Fundació n IVI-Instituto Universitario IVI, Valencia, Spain.SampleControl and pre-eclampsia-induced pregnant Wistar rats exposed to chronic SC administration.Methods We evaluated the use of SC, which was tested as a potential therapeutic tool to maintain vasodilatation in complicated pregnancies. We have demonstrated previously that SC shows a hypotensive selective effect in normal rat pregnancies when compared with nonpregnant animals.Main outcome measures Maternal blood pressure, weight and mortality during pre-and postnatal development, maternal blood cellularity and haemodynamic changes with maternal and fetal Doppler quantitative indices.Results SC restores normal values of blood pressure, cell count and proteinuria for maternal syndrome. In offspring, SC improves weight gain and increases survival rates without fetotoxic effects. According to the haemodynamic results, SC has a significant effect on the resistance index in the uterine artery in pre-eclamptic animals, as it restores normal values to correlate with an increase in fetal perfusion through the ductus venosus.Conclusions These results suggest that SC administration during pregnancy may have a potential benefit for the treatment of hypertension during pregnancy by reversing the maternal effects of pre-eclampsia and by improving uteroplacental and fetal perfusion.

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Section: Discussionmentioning

confidence: 93%

Sildenafil citrate improves perinatal outcome in fetuses from pre‐eclamptic rats

Herraiz

Pellicer

Serra

et al. 2012

BJOG

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“…In order to evaluate whether the blood viscosity changes caused by pregnancy or the administration of SC could alter the haemodynamic results, a maternal blood sample was obtained from the tail veins on days E8, E11 and E18 to study this factor 25 …”

Section: Methodsmentioning

confidence: 99%

Haemodynamic effects of long-term administration of sildenafil in normotensive pregnant and non-pregnant rats

Pellicer

Herraiz

Cauli

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Objective To determine the effects of chronic administration of sildenafil citrateon healthy pregnant rats.Design In vivo animal experimental study.Setting Fundació n IVI-Instituto Universitario IVI, Valencia, Spain.Sample Pregnant and non-pregnant Wistarrats exposed to chronic administration of sildenafil.Methods Placental cross-barrier and feto-maternal relationship levels, maternal blood pressure, and haemodymamic effects on uterine arteries were evaluated. The effect of growth on weight and fetal tissues, and on perinatal outcome, was investigated.Main outcome measures Maternal blood pressure, blood viscosity, vascular indices of uterine arteries and fetal ductus venosus, plasmatic levels of sildenafil, embryo/fetal and litter weights, perinatal/postnatal survival rates.Results Sildenafil citrate crossed the placenta. The maternal and fetal levels of sildenafil, and its metabolite desmethyl-sildenafil, demonstrated a positive linear correlation in treated pregnant animals versus controls; a selective maternal hypotensive effect without changes in uterine vascular resistance was noted on days E8 and E11 (embryonic day). The lower pulsatility index of the ductus venosus on day E18 suggests fetal overflow at the end of the pregnancy. Effects on offspring were placental and liver enlargement, and increased fetal weight gain in the second half of pregnancy (irrespective of liver enlargement) and at birth. Perinatal and postnatal survival rates in the sildenafil group remained unaltered. No haemodynamic effects were evident in non-pregnant animals.Conclusions In normotensive rats, sildenafil appears to have a selective effect at the onset of pregnancy, implying increased fetal blood supply, and increased fetal weight, and placental and liver enlargement, but no increased perinatal mortality.

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“…This result was once again compared with the Doppler examinations of the individual blood vessels. The exact test procedure and hemodynamic significance of the Doppler indices have been described in great detail in other studies [22]. The mean gestation age on performance of the examinations was 34 weeks (range 26 to 42 weeks).…”

Section: Examination Methodsmentioning

confidence: 99%

Predictive value of a single CTG, ultrasound and Doppler examination to diagnose acute and chronic placental insufficiency in multiple pregnancies

Joern

Schroeder²,

Saßen³

et al. 1997

Jpme

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A non-stress test, an ultrasound biometry (biparietal and abdominal diameter) and a Doppler sonography blood flow measurement (fetal descending aorta, umbilical artery and fetal middle cerebral artery) were performed in the third trimester of 130 multiple pregnancies. These three methods were compared in terms of their prognostic value for fetal growth retardation (81 from 263 children; defined as weight at birth < 10 percentile) and a pathological "fetal outcome" (76 from 263 children, defined as 5-min-Apgar < 8, umbilical artery-pH < 7.20 and transfer to neonatal intensive care unit). Fetal growth retardation could best be predicted by means of the Doppler results for all three blood vessels ("total Doppler result") (sensitivity of 75.9%). Doppler results for all three blood vessels showed the best result in predicting a pathological "fetal outcome"; the sensitivity was 60.3%. The biometric examinations with ultrasound and the non-stress test produced worse results compared to Doppler sonography. Doppler velocimetry of only one blood vessel showed worse results compared to Doppler velocimetry of more than one blood vessel. Doppler sonography should be performed as a routine test for all multiple pregnancies. More intensive pregnancy surveillance is urgently recommended with pathological findings.

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Spectral Doppler Sonography: Waveform Analysis and Hemodynamic Interpretation

Cited by 13 publications

References 42 publications

Sildenafil citrate improves perinatal outcome in fetuses from pre‐eclamptic rats

Sildenafil citrate improves perinatal outcome in fetuses from pre‐eclamptic rats

Haemodynamic effects of long-term administration of sildenafil in normotensive pregnant and non-pregnant rats

Predictive value of a single CTG, ultrasound and Doppler examination to diagnose acute and chronic placental insufficiency in multiple pregnancies

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