Total uterine artery blood volume flow rate in nulliparous women is associated with birth weight and gestational age at delivery

McKelvey, Alastair; Pateman, K.; Balchin, Imelda; Peebles, Donald; Rodeck, Charles H.; David, Anna L.

doi:10.1002/uog.15917

Cited by 24 publications

(23 citation statements)

References 31 publications

(31 reference statements)

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“…2,19,20 Similar positive associations between flow rate and GA have also been reported. 3,20 These studies show a moderate association between flow and GA in the first trimester, 3 but a comparatively weaker association in the second and third trimester, 20 suggesting that the most extensive UtA remodeling occurs during the first trimester. Our findings in second and third trimester subjects were consistent with this, and no substantial blood flow changes in the late second and third trimesters were found.…”

Section: Discussionmentioning

confidence: 93%

Assessment of uterine artery geometry and hemodynamics in human pregnancy with 4d flow mri and its correlation with doppler ultrasound

Hwuang

Vidorreta

Schwartz

et al. 2018

Magnetic Resonance Imaging

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Background: Uterine artery (UtA) hemodynamics might be used to predict risk of hypertensive pregnancy disorders, including preeclampsia and intrauterine growth restriction. Purpose or Hypothesis: To determine the feasibility of 4D flow MRI in pregnant subjects by characterizing UtA anatomy, computing UtA flow, and comparing UtA velocity, and pulsatility and resistivity indices (PI, RI) with transabdominal Doppler ultrasound (US). Study Type: Prospective cross-sectional study from June 6, 2016, to May 2, 2018. Population or Subjects or Phantom or Specimen or Animal Model: Forty-one singleton pregnant subjects (age [range] = 27.0 ± 5.9 [18–41] years) in their second or third trimester. We additionally scanned three subjects who had prepregnancy diabetes or chronic hypertension. Field Strength/Sequence: The subjects underwent UtA and placenta MRI using noncontrast angiography and 4D flow at 1.5T. Assessment: UtA anatomy was described based on 4D flow-derived noncontrast angiography, while UtA flow properties were characterized by net flow, systolic/mean/diastolic velocity, PI and RI through examination of 4D flow data. PI and RI are standard hemodynamic parameters routinely reported on Doppler US. Statistical Tests: Spearman’s rank correlation, Wilcoxon signed rank tests, and Bland-Altman plots were used to preliminarily investigate the relationships between flow parameters, gestational age, and Doppler US. Results: 4D flow MRI and UtA flow quantification was feasible in all subjects. There was considerable heterogeneity in UtA geometry in each subject between left and right UtAs and between subjects. Mean 4D flow-based parameters were: mean bilateral flow rate = 605.6 ± 220.5 mL/min, PI = 0.72 ± 0.2, and RI = 0.47 ± 0.1. Bilateral flow did not change with gestational age. We found that MRI differed from US in terms of lower PI (mean difference −0.1) and RI (mean difference < −0.1) with Wilcoxon signed rank test P = 0.05 and P = 0.13, respectively. Data Conclusion: 4D flow MRI is a feasible approach for describing UtA anatomy and flow in pregnant subjects. Level of Evidence: Technical Efficacy: Stage 1

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Section: Discussionmentioning

confidence: 93%

Assessment of uterine artery geometry and hemodynamics in human pregnancy with 4d flow mri and its correlation with doppler ultrasound

Hwuang

Vidorreta

Schwartz

et al. 2018

Magnetic Resonance Imaging

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“…This mirrors the human singleton pregnancy where total uterine artery blood volume flow in the first or early second trimesters is positively correlated to birth weight (McKelvey et al . ), and total uterine blood flow is reduced in fetal growth restricted (FGR) pregnancies (Konje et al . ).…”

Section: Introductionmentioning

confidence: 99%

Guinea pig models for translation of the developmental origins of health and disease hypothesis into the clinic

Morrison

Botting

Darby

et al. 2018

The Journal of Physiology

116

108

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Over 30 years ago Professor David Barker first proposed the theory that events in early life could explain an individual's risk of non-communicable disease in later life: the developmental origins of health and disease (DOHaD) hypothesis. During the 1990s the validity of the DOHaD hypothesis was extensively tested in a number of human populations and the mechanisms underpinning it characterised in a range of experimental animal models. Over the past decade, researchers have sought to use this mechanistic understanding of DOHaD to develop therapeutic interventions during pregnancy and early life to improve adult health. A variety of animal models have been used to develop and evaluate interventions, each with strengths and limitations. It is becoming apparent that effective translational research requires that the animal paradigm selected mirrors the tempo of human fetal growth and development as closely as possible so that the effect of a perinatal insult and/or therapeutic intervention can be fully assessed. The guinea pig is one such animal model that over the past two decades has demonstrated itself to be a very useful platform for these important reproductive studies. This review highlights similarities in the in utero development between humans and guinea pigs, the strengths and limitations of the guinea pig as an experimental model of DOHaD and the guinea pig's potential to enhance clinical therapeutic innovation to improve human health.

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“…Our observational data can add only limited information regarding this issue. The uterine volume blood flow may still be a determinant for fetal growth when it is pathologically low, besides the uterine flow may be more important earlier in pregnancy by having an effect on placental growth (188,189) .…”

Section: Flowmentioning

confidence: 99%

The 4-vessel Sampling Approach to Integrative Studies of Human Placental Physiology <em>In Vivo</em>

Holme

Holm

Roland

et al. 2017

JoVE

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The human placenta is highly inaccessible for research while still in utero. The current understanding of human placental physiology in vivo is therefore largely based on animal studies, despite the high diversity among species in placental anatomy, hemodynamics and duration of the pregnancy. The vast majority of human placenta studies are ex vivo perfusion studies or in vitro trophoblast studies. Although in vitro studies and animal models are essential, extrapolation of the results from such studies to the human placenta in vivo is uncertain. We aimed to study human placenta physiology in vivo at term, and present a detailed protocol of the method. Exploiting the intraabdominal access to the uterine vein just before the uterine incision during planned cesarean section, we collect blood samples from the incoming and outgoing vessels on the maternal and fetal sides of the placenta. When combining concentration measurements from blood samples with volume blood flow measurements, we are able to quantify placental and fetal uptake and release of any compound. Furthermore, placental tissue samples from the same mother-fetus pairs can provide measurements of transporter density and activity and other aspects of placental functions in vivo. Through this integrative use of the 4-vessel sampling method we are able to test some of the current concepts of placental nutrient transfer and metabolism in vivo, both in normal and pathological pregnancies. Furthermore, this method enables the identification of substances secreted by the placenta to the maternal circulation, which could be an important contribution to the search for biomarkers of placenta dysfunction.

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Total uterine artery blood volume flow rate in nulliparous women is associated with birth weight and gestational age at delivery

Abstract: Objectives To investigate the relationship between total uterine artery blood volume flow rate (TVFR)

Cited by 24 publications

References 31 publications

Assessment of uterine artery geometry and hemodynamics in human pregnancy with 4d flow mri and its correlation with doppler ultrasound

Assessment of uterine artery geometry and hemodynamics in human pregnancy with 4d flow mri and its correlation with doppler ultrasound

Guinea pig models for translation of the developmental origins of health and disease hypothesis into the clinic

The 4-vessel Sampling Approach to Integrative Studies of Human Placental Physiology <em>In Vivo</em>

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