The effect of maternal hypothermic cardiopulmonary bypass on fetal lamb temperature, hemodynamics, oxygenation, and acid-base balance

Pardi, Giorgio; Ferrari, María Rosa; Iorio, Fiore S.; Acocella, Fabio; Boero, Veronica; Berlanda, Nicola; Monaco, Ario; Reato, Claudio; Santoro, Francesco; Cetin, Irene

doi:10.1016/j.jtcvs.2003.08.036

Cited by 14 publications

(2 citation statements)

References 18 publications

(18 reference statements)

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“…In fact, increased peripheral vascular resistance in women with chronic arterial hypertension is mediated by some agents that cross the placenta and, upon the activation of specific receptors in the foetal vessel walls, can induce local circulatory changes [36,37]. Likely targets include the foetal aorta as its Doppler frequency spectrum is modulated by a variety of circulatory variables as foetal cardiac output, arterial impedance of the peripheral vascular system and blood viscosity [14].…”

Section: Discussionmentioning

confidence: 99%

Foetal aortic flow velocity waveforms in healthy and hypertensive pregnant women

Guedes-Martins

Cunha

Saraiva

et al. 2014

Cardiovasc Ultrasound

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BackgroundThe foetal aortic Doppler frequency spectrum is influenced by cardiac output and contractility of the foetal heart as well as vascular compliance, blood viscosity and impedance of the arterial vascular system. The present study aimed at comparing Doppler flow pulsatility (PI) and resistance (RI) indexes of foetal proximal descending aorta (AoF) in the first, second and third trimesters of pregnancy, in low risk women and in those with chronic arterial hypertension, who had normal pregnancy outcomes.MethodsA longitudinal and prospective study was carried out in 101 singleton pregnancies (71 low-risk pregnancies and 30 with essential hypertension). Multivariate regression had to be considered due to the experiment’s nature: two different indexes were read on the same set of individuals, once at each trimester of the pregnancy [1st (11–14 weeks), 2nd (19–22 weeks) and 3rd (28–32 weeks) trimesters]. The response variable was denoted as index d, in a subject with hypertensive status h (hypertensive or normotensive), at continuous time t.ResultsIn both groups, AoF-PI and AoF-RI showed a small, but significant increase from the first to the second (1.850 ± 0.339 vs 2.110 ± 0.242 for PI, and 0.829 ± 0.068 vs 0.857 ± 0.038 for RI; p < 0.001) and the first to the third (1.850 ± 0.339 vs 2.163 ± 0.282 for PI, and 0.829 ± 0.068 vs 0.864 ± 0.037 for RI; p < 0.001) trimesters of pregnancy. The global model showed that while AoF-RI trends were converging as time progressed, the AoF-PI values exhibited a divergent trend (p < 0.05).ConclusionsChronic stable hypertension in pregnancies with normal outcome, evidences an upward regular trend of foetal descending aorta pulsatility index that is similar to the normotensive condition.

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Section: Discussionmentioning

confidence: 99%

Foetal aortic flow velocity waveforms in healthy and hypertensive pregnant women

Guedes-Martins

Cunha

Saraiva

et al. 2014

Cardiovasc Ultrasound

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“…Normal interactions between maternal and fetal circulation in the placenta are necessary for maintaining normal fetal growth through a healthy rate of nutrient and oxygen exchange. Impaired invasion of fetal trophoblasts into maternal decidua can hypothetically cause intrauterine growth restriction (IUGR) and is clinically evaluated indirectly by the resulting upstream effects on the uterine color Doppler ultrasound and downstream effects on the fetal circulation caused by hypoxemia and lactic acidosis (22). These changes enhance the widespread use of ultrasonography in diagnosis, follow-up and management of fetuses with IUGR or who are considered high risk for IUGR.…”

Section: Discussionmentioning

confidence: 99%

Correlating Placental ADC Values with Gestational Age and Grannum Class in Normal Placentas

et al. 2018

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Background: Recently there have been attempts to link fetal growth retardation to placental morphology as well as apparentdiffusion coefficient (ADC) values. Objectives: The purpose of this study was to investigate the possible correlation of apparent diffusion coefficient (ADC) values of normal placentas with different gestational ages and various Grannum grades (Gg). Patients and Methods: Thirty-eight women were included in this study. All women with singleton pregnancies referred for fetal MRI who were proven normal in pre/postnatal follow-up were included in the study. All placentas were evaluated by ultrasound trans-abdominally. The placenta was assessed for maximal thickness, subjective shape, presence of possible infarcts, sub-placental, and subchorionic hemorrhage. Placentas were also evaluated for G-grading and signal intensities in T2 half-fourier acquisition single-shot turbo spin-echo (HASTE) images. Diffusion weighted imaging (DWI) images were done using two b-value sets (0, 1000 and 50, 400, 800). Largest possible regions of interest (ROI) were drawn over the placenta and ADC values were correlated with gestational-age and Gg using linear regression and Kruskal-Wallis, respectively. Results: There were 11, 18, 9, 0 patients with normal looking placentas with Gg of 0, 1, 2, and 3 respectively. ADC values obtained from b values of 0, and 1000 show a significant correlation with gestational-age (R 2 = 0.60, P = 0.000) and Gg (P = 0.004) respectively, while ADC values obtained from b values of 50, 400, and 800 did not show significant correlation with gestational age (R 2 = 0.087, P = 0.073) or Gg (P = 0.236). Conclusion: ADC values which were obtained from sets of b values of 0 and 1000 correlated with placental maturity (both gestational age (GA) and Grannum grades). This can be attributed to lower b-values covering the microperfusion in addition to diffusion characteristics of the tissue.

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Effects on the Fetus of Major Maternal Anesthetic Complications

Plaat

Bedson

2012

Anesthesia and the Fetus

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The effect of maternal hypothermic cardiopulmonary bypass on fetal lamb temperature, hemodynamics, oxygenation, and acid-base balance

Abstract: Deep maternal hypothermic cardiopulmonary bypass was associated with reversible modifications in fetal cardiovascular parameters, blood gases, and acid-base balance and therefore with fetal survival. On the contrary, fetuses did not survive to a very deep hypothermia below 18 degrees C.

Cited by 14 publications

References 18 publications

Foetal aortic flow velocity waveforms in healthy and hypertensive pregnant women

Foetal aortic flow velocity waveforms in healthy and hypertensive pregnant women

Correlating Placental ADC Values with Gestational Age and Grannum Class in Normal Placentas

Effects on the Fetus of Major Maternal Anesthetic Complications

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