Ultrasound and Doppler Management of Intrauterine Growth Restriction

Carrera, J. M.; Figueras, F.; Meler, E.

doi:10.5005/jp-journals-10009-1148

Donald School Journal of Ultrasound in Obstetrics and Gynecology

2010

DOI: 10.5005/jp-journals-10009-1148

|View full text |Cite

Ultrasound and Doppler Management of Intrauterine Growth Restriction

J. M. Carrera¹,

F. Figueras²,

E. Meler³

Abstract: Review of present knowledge about fetal growth, and clinical and ultrasonography diagnosis of Intrauterine growth restriction by means of 2D and 3D. The review included the diagnosis of type of IUGR and the study of fetal deterioration (Chronic Tests and Acute Markers). Also the obstetrics management.

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2012

2017

Publication Types

Select...

Article2

Relationship

Self Cite0

Independent2

Authors

Journals

Cited by 2 publications

(1 citation statement)

References 109 publications

(129 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinically, the UA velocity waveforms are most commonly evaluated in terms of the UA pulsatility index (1,5), defined as the ratio of peak-topeak velocity to the mean velocity over a cardiac cycle; this is widely viewed as a surrogate for downstream fetoplacental vascular function and thus oxygenation of the fetus (1). This conclusion is broadly valid because pulsation in the UA is correlated with defects in the fetoplacental vessels (7,36) and related to the downstream placental vascular resistance (1). However, a major limitation of measuring pulsatility is that it varies substantially between placental and fetal ends of the umbilical cord (52).…”

mentioning

confidence: 99%

Ultrasound detection of altered placental vascular morphology based on hemodynamic pulse wave reflection

Rahman

Zhou

Yee

et al. 2017

American Journal of Physiology-Heart and Circulatory Physiology

View full text Add to dashboard Cite

Abnormally pulsatile umbilical artery (UA) Doppler ultrasound velocity waveforms are a hallmark of severe or early onset placental-mediated intrauterine growth restriction (IUGR), whereas milder late onset IUGR pregnancies typically have normal UA pulsatility. The diagnostic utility of these waveforms to detect placental pathology is thus limited and hampered by factors outside of the placental circulation, including fetal cardiac output. In view of these limitations, we hypothesized that these Doppler waveforms could be more clearly understood as a reflection phenomenon and that a reflected pulse pressure wave is present in the UA that originates from the placenta and propagates backward along the UA. To investigate this, we developed a new ultrasound approach to isolate that portion of the UA Doppler waveform that arises from a pulse pressure wave propagating backward along the UA. Ultrasound measurements of UA lumen diameter and flow waveforms were used to decompose the observed flow waveform into its forward and reflected components. Evaluation of CD1 and C57BL/6 mice at embryonic day (E)15.5 and E17.5 demonstrated that the reflected waveforms diverged between the strains at E17.5, mirroring known changes in the fractal geometry of fetoplacental arteries at these ages. These experiments demonstrate the feasibility of noninvasively measuring wave reflections that originate from the fetoplacental circulation. The observed reflections were consistent with theoretical predictions based on the area ratio of parent to daughters at bifurcations in fetoplacental arteries suggesting that this approach could be used in the diagnosis of fetoplacental vascular pathology that is prevalent in human IUGR. Given that the proposed measurements represent a subset of those currently used in human fetal surveillance, the adaptation of this technology could extend the diagnostic utility of Doppler ultrasound in the detection of placental vascular pathologies that cause IUGR. Here, we describe a novel approach to noninvasively detect microvascular changes in the fetoplacental circulation using ultrasound. The technique is based on detecting reflection pulse pressure waves that travel along the umbilical artery. Using a proof-of-principle study, we demonstrate the feasibility of the technique in two strains of experimental mice.

show abstract

mentioning

confidence: 99%

Ultrasound detection of altered placental vascular morphology based on hemodynamic pulse wave reflection

Rahman

Zhou

Yee

et al. 2017

American Journal of Physiology-Heart and Circulatory Physiology

View full text Add to dashboard Cite

show abstract

Comparison between antenatal neurodevelopmental test and fetal Doppler in the assessment of fetal well being

Kurjak

Talić

Honemeyer

et al. 2012

Journal of Perinatal Medicine

View full text Add to dashboard Cite

Aims: The primary aim of this study was to compare circulatory changes in the fetal brain under certain pathological conditions with alterations in fetal behavior. Patients and methods: A prospective longitudinal cohort study on fetal behavior of fetuses from singleton pregnancies between the 28 th and 38 th gestational week in the period from March 2009 to October 2011 was undertaken. There were 596 fetuses in the high-risk group and 273 fetuses in the low-risk group. Elevated umbilical artery Doppler pulsatility index and reduced middle cerebral artery pulsatility index obtained in the absence of fetal movements were considered abnormal. The Kurjak Antenatal Neurodevelopmental Test (KANET) was used to assess fetal behavior. Results: Statistically signifi cant differences in the distribution of normal, abnormal, and borderline KANET scores between low-risk and high-risk groups were found. Furthermore, 596 fetuses from the high-risk group were subdivided into subgroups according to the risk factor. The largest proportion of abnormal KANET scores (23.9 % ) was in the subgroup of fetuses whose mothers had an offspring diagnosed with cerebral palsy (23.9 % ), followed by the proportion of borderline KANET scores in the subgroup of fetuses from febrile mothers (12.7 % ). Fetal behavior was signifi cantly different between the normal group and the following subgroups of fetuses: fetal growth restriction (FGR), gestational diabetes mellitus, threatened preterm birth, antepartal hemorrhage, maternal fever, sibling with cerebral palsy, and polyhydramnios. Conclusions: A new clinical application of the KANET test in early identifi cation of fetuses at risk for adverse neurological outcome was demonstrated.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

hi@scite.ai

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Ultrasound and Doppler Management of Intrauterine Growth Restriction

Cited by 2 publications

References 109 publications

Ultrasound detection of altered placental vascular morphology based on hemodynamic pulse wave reflection

Ultrasound detection of altered placental vascular morphology based on hemodynamic pulse wave reflection

Comparison between antenatal neurodevelopmental test and fetal Doppler in the assessment of fetal well being

Contact Info

Product

Resources

About