Umbilical venous blood flow measurement: accuracy and reproducibility

Figueras, F.; Fernández, Santiago Huerta; Hernández‐Andrade, Edgar; Gratacós, Eduard

doi:10.1002/uog.5306

Cited by 51 publications

(58 citation statements)

References 43 publications

(93 reference statements)

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“…42 The ICC compares the variance of different measurements with the total variance of all measurements; with the variance derived from ANOVA using a linear mixed model in this analysis. 45 Intrasonographer and intersonographer ICC were excellent for measurement of the UCV diameter and PV, with similar or superior values to other published results. 43,44 The ICC is considered superior to Pearson's and Spearman's analyses as it takes into account the differences between observers 42 and the variance of all measurements.…”

Section: Discussionsupporting

confidence: 84%

“…The ICC value can range from 0 to 1, with a value greater than 0.8 indicating almost perfect agreement. 25,44,45 Published data indicated that the largest umbilical vein diameter occurs during the third trimester, somewhere between 32 and 42 weeks GA. 45 Intrasonographer and intersonographer ICC were excellent for measurement of the UCV diameter and PV, with similar or superior values to other published results.…”

Section: Discussionmentioning

confidence: 99%

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Reference ranges for the intra‐amniotic umbilical cord vein diameter, peak velocity and blood flow in a regional NSW population

Spurway

Logan

Pak

et al. 2017

Australas J Ultrason Med

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Aim: To construct gestational age (GA)-related reference ranges of the intra-amniotic umbilical cord vein (UCV) diameter, peak velocity (PV) and blood flow (Qucv) using a Central West New South Wales population. Materials and Methods: This was a prospective, quasi-experimental study of low risk, singleton pregnancies (n = 321) between 16 and 42 weeks of gestation. Participation was voluntary following informed consent. The UCV diameter and PV were measured using B mode and duplex Doppler respectively, and Qucv calculated. Percentile values and reference range graphs were established using quantile regression modelling in R statistical software. Intraclass correlation coefficients (ICCs) were calculated to assess the intra and intersonographer reliability. Results: Reference ranges for the UCV diameter, PV and Qucv were established and graphed. All three UCV measurements increased with advancing GA, with both diameter and Qucv exhibiting a decline in the late third trimester. The intrasonographer and intersonographer ICCs for the UCV diameter and PV showed almost perfect agreement within and between sonographers. Conclusion: Gestational age-related reference ranges for the UCV diameter, PV and Qucv were developed using quantile regression from a cohort of low risk, singleton pregnancies in Central West NSW. These reference ranges have the potential to assist in the diagnosis and monitoring of fetal growth restriction.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Reference ranges for the intra‐amniotic umbilical cord vein diameter, peak velocity and blood flow in a regional NSW population

Spurway

Logan

Pak

et al. 2017

Australas J Ultrason Med

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“…Fetal echocardiography-derived Doppler flow measures such as pulsatility index calculations are a measure of vascular resistance, not flow. Doppler-derived volumetric calculations of umbilical venous flow as an absolute measure of placental blood flow, or perhaps as a relative fraction of overall fetal combined cardiac output may be more informative [30]. Other methodologies such as MRI techniques will add to the capacity to better gauge the relationship between blood flow and placental structure and function during pregnancy, which will complement fetal echocardiography and add important insights to our understanding [10, 31].…”

Section: Discussionmentioning

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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“…[11-14]) or 3D power Doppler measurements of the placental blood flow (e.g. [15-19]), and have noted the effect that different placental attachments in utero have on the transport efficiency.…”

Section: Discussionmentioning

confidence: 99%

Centrality of the Umbilical Cord Insertion in a Human Placenta Influences the Placental Efficiency☆

et al. 2009

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Goal: We assess the effect on placental efficiency of the non-centrality of the umbilical cord insertion and on chorionic vascular distribution to determine if cord centrality measurably affects placental function as reflected in birth weight. Materials and Methods:1,225 placentas collected from a prospective cohort had digital photographs of the chorionic plate. Of these, 1023 were term, 44 had velamentous cord insertion and 12 had missing clinical data, leaving N=967 (94.5 %) cases for analysis. Mathematical tools included a dynamical stochastic growth model of placental vasculature, Fourier analysis of radial parameterization of placental perimeters, and relative chorionic vascular density (a measure of "gaps" in the vascular coverage) derived from manual tracings of the fetal chorionic surface images. Bivariate correlations used Pearson's or Spearman's rank correlation as appropriate, with p<0.05 considered significant. Results:The correlation of the standard deviation of the placental radius (a measure of nonroundness of the placenta) with cord displacement was negligible (r=0.01). Empirical simulations of the vascular growth model with cord displacement showed no deviation from a normal round-tooval placental shape for cord displacement of 10 -50% of placental radius. The correlation of the metabolic scaling exponent β with cord displacement measured by Fourier analysis is 0.17 (p < 0.001). Analysis of the chorionic vascular density in traced images shows a high correlation of the © 2009 Elsevier Ltd. All rights reserved.Corresponding author: Michael Yampolsky, PhD Department of Mathematics University of Toronto 40 St. George Street, Toronto, Canada M5S2E4 yampolsky.michael@gmail.com. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptPlacenta. Author manuscript; available in PMC 2010 December 1. Conclusion:Non-central cord insertion has little measurable correlation with placental shape in observed or simulated placentas. However, placentas with a displaced cord show a markedly reduced transport efficiency, reflected in a larger value of β and hence in a smaller birth weight for a given placental weight. Placentas with a non-central cord insertion have a sparser chorionic vascular distribution, as measured by the relative vascular distance. Even if typically a placenta with a noncentral insertion is of a normal round shape, its vasculature is less metabolically effective. These findings demonstrate another method by which altered placental structure may affect the fetal environment, influencing birth weight and potentially c...

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Umbilical venous blood flow measurement: accuracy and reproducibility

Abstract: ABSTRACT

Cited by 51 publications

References 43 publications

Reference ranges for the intra‐amniotic umbilical cord vein diameter, peak velocity and blood flow in a regional NSW population

Reference ranges for the intra‐amniotic umbilical cord vein diameter, peak velocity and blood flow in a regional NSW population

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

Centrality of the Umbilical Cord Insertion in a Human Placenta Influences the Placental Efficiency☆

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