The role of Doppler technology in the evaluation of fetal hypoxia

Renzo, Gian Carlo Di; Luzi, Giampaolo; Cucchia, Gianni; Caserta, G.; Fusaro, Paola; Perdikaris, A.; Cosmi, E. V.

doi:10.1016/0378-3782(92)90162-a

Cited by 28 publications

(10 citation statements)

References 20 publications

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“…2C). The ratio of the PI of the UA over the PI of the MCA, which indicates fetal hypoxia, 12 was also significantly reduced by treatment with ISDN (P < .003).…”

Section: Pulsatility Indices Of the Ua And Fetal Mcamentioning

confidence: 91%

A Long‐term Transdermal Nitric Oxide Donor Improves Uteroplacental Circulation in Women With Preeclampsia

Nakatsuka

Takata

Tada

et al. 2002

J of Ultrasound Medicine

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Objective. To determine the effects of long-term transdermal administration (range, 4-30 days; mean ± SD, 11.1 ± 7.2 days) of isosorbide dinitrate, a nitric oxide donor, in preeclamptic women. Methods. We studied uterine and fetoplacental circulation of 12 preeclamptic women with oligohydramnios and an elevated pulsatility index in the uterine arteries. Results. Transdermal isosorbide dinitrate significantly suppressed the blood pressure of patients. Pulsed Doppler ultrasonography revealed that the average pulsatility index in the uterine arteries was significantly reduced by treatment with isosorbide dinitrate (P < .003). The average pulsatility index in the umbilical artery was also significantly reduced (P < .004). Furthermore, the size of the amniotic fluid pocket increased approximately 4-fold by treatment with isosorbide dinitrate. Conclusions. Long-term transdermal administration of isosorbide dinitrate improves fetoplacental circulation and may be effective therapy for avoiding maternal hypertension and oligohydramnios in some preeclamptic women.

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“…2C). The ratio of the PI of the UA over the PI of the MCA, which indicates fetal hypoxia, 12 was also significantly reduced by treatment with ISDN (P < .003).…”

Section: Pulsatility Indices Of the Ua And Fetal Mcamentioning

confidence: 91%

A Long‐term Transdermal Nitric Oxide Donor Improves Uteroplacental Circulation in Women With Preeclampsia

Nakatsuka

Takata

Tada

et al. 2002

J of Ultrasound Medicine

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“…Three waveforms were measured and the average taken for analysis. The ratio of MCA PI-to-UA PI was calculated as the cerebro-placental resistance ratio (CPR), an index of the circulatory resistance ratio of the cerebrovasculature-to-placental vasculature on the fetal side [18]. A healthy normal CPR is > 1, indicating a high cerebrovascular resistance relative to a low placental vascular resistance [19].…”

Section: Methodsmentioning

confidence: 99%

Characterization of the Placenta in the Newborn with Congenital Heart Disease: Distinctions Based on Type of Cardiac Malformation

et al. 2018

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The placenta is a complex organ that influences prenatal growth and development, and through fetal programming impacts postnatal health and well-being lifelong. Little information exists on placental pathology in the presence of congenital heart disease (CHD). Our objective is to characterize the placenta in CHD and investigate for distinctions based on type of malformation present. Placental pathology from singleton neonates prenatally diagnosed and delivered at > 37 weeks gestation was analyzed. Placental findings of absolute weight, placental weight-to-newborn birth weight ratio, chorangiosis, villus maturity, thrombosis, and infarction were recorded and analyzed based on four physiological categories of CHD: (1) single ventricle-aortic obstruction, (2) single ventricle-pulmonic obstruction, (3) two-ventricle anomalies, and (4) transposition of the great arteries (TGA). Associations between fetal Doppler assessments of middle cerebral/umbilical arterial flow and placental findings were investigated. A total of 120 cases of complex CHD were analyzed. Overall placental-to-birth weight ratios were < 10th percentile for 77% and < 3rd percentile for 49% with abnormalities of chorangiosis (18%), hypomature villi (15%), thrombosis (41%), and infarction (17%) common. There was no association between fetal Doppler flow measures and placental abnormalities. Newborns with TGA had the greatest degree of placental abnormality. Placentas of newborns with CHD are smaller than expected and manifest a number of vascular abnormalities, with TGA most prominent. Fetal Doppler does not correlate with these abnormalities. Studies investigating the relationship between placental abnormalities and postnatal outcomes may offer insight into the fetal origins of outcome variability in CHD.

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“…The existence of such autoregulatory mechanism in the developing fetus has been demonstrated in animal experiments (11,12). Similar mechanisms have been considered the underlying pathophysiology of the increased blood flow in the MCA of fetus complicated by growth restriction or hypoxia (7,8).…”

Section: Discussionmentioning

confidence: 94%

“…The mechanism of decrease in the impedance of the renal artery is uncertain. In compromised fetuses or fetuses under stress, there is redistribution of blood flow to vital organs with reduction of blood flow to less vital organs, such as the kidney (7,12). However, we found the impedance of the renal artery, indeed, decrease rather than increase after amniotomy.…”

Section: Discussionmentioning

confidence: 99%

“…The availability of Doppler ultrasonography has enabled the non‐invasive study of fetal circulation and hemodynamics. Apart from the umbilical vessels, blood flow through other vessels, such as the middle cerebral artery (MCA), the ductus venosum, and the renal artery, are also altered in compromised fetuses, such as intrauterine growth retardation (7–9). Because amniotomy represents a strong stimulus to the fetus and is associated with changes in fetal heart rate, we postulate that fetal blood flow through these vessels may also be altered by amniotomy.…”

mentioning

confidence: 99%

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