Chronic Fetal Distress. Research on Placental Blood Flow and Therapy

Author(s):  
G. Pontonnier ◽  
H. Grandjean ◽  
M. F. Sarramon ◽  
J. Degoy ◽  
R. Guiraud ◽  
...  
Reproduction ◽  
2017 ◽  
Vol 153 (3) ◽  
pp. R85-R96 ◽  
Author(s):  
E Mourier ◽  
A Tarrade ◽  
J Duan ◽  
C Richard ◽  
C Bertholdt ◽  
...  

In human obstetrics, placental vascularisation impairment is frequent as well as linked to severe pathological events (preeclampsia and intrauterine growth restriction), and there is a need for reliable methods allowing non-invasive evaluation of placental blood flow. Uteroplacental vascularisation is complex, and animal models are essential for the technical development and safety assessment of these imaging tools for human clinical use; however, these techniques can also be applied in the veterinary context. This paper reviews how ultrasound-based imaging methods such as 2D and 3D Doppler can provide valuable insight for the exploration of placental blood flow both in humans and animals and how new approaches such as the use of ultrasound contrast agents or ultrafast Doppler may allow to discriminate between maternal (non-pulsatile) and foetal (pulsatile) blood flow in the placenta. Finally, functional magnetic resonance imaging could also be used to evaluate placental blood flow, as indicated by studies in animal models, but its safety in human pregnancy still requires to be confirmed.


1978 ◽  
Vol 53 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Lena Mårtensson ◽  
Per-Ove B. Sjöquist ◽  
Leif Bjellin ◽  
Anthony M. Carter

1992 ◽  
Vol 263 (3) ◽  
pp. H919-H928 ◽  
Author(s):  
S. M. Bradley ◽  
F. L. Hanley ◽  
B. W. Duncan ◽  
R. W. Jennings ◽  
J. A. Jester ◽  
...  

Successful fetal cardiac bypass might allow prenatal correction of some congenital heart defects. However, previous studies have shown that fetal cardiac bypass may result in impaired fetal gas exchange after bypass. To investigate the etiology of this impairment, we determined whether fetal cardiac bypass causes a redistribution of fetal regional blood flows and, if so, whether a vasodilator (sodium nitroprusside) can prevent this redistribution. We also determined the effects of fetal cardiac bypass with and without nitroprusside on fetal arterial blood gases and hemodynamics. Eighteen fetal sheep were studied in utero under general anesthesia. Seven fetuses underwent bypass without nitroprusside, six underwent bypass with nitroprusside, and five were no-bypass controls. Blood flows were determined using radionuclide-labeled microspheres. After bypass without nitroprusside, placental blood flow decreased by 25–60%, whereas cardiac output increased by 15–25%. Flow to all other fetal organs increased or remained unchanged. Decreased placental blood flow after bypass was accompanied by a fall in PO2 and a rise in PCO2. Nitroprusside improved placental blood flow, cardiac output, and arterial blood gases after bypass. Thus fetal cardiac bypass causes a redistribution of regional blood flow away from the placenta and toward the other fetal organs. Nitroprusside partially prevents this redistribution. Methods of improving placental blood flow in the postbypass period may prove critical to the success of fetal cardiac bypass.


Author(s):  
Suraphan Sajapala

ABSTRACT With the appearance of the latest three/four-dimensional (3D/4D) ultrasound machine (HDliveFlow, Voluson E10, GE Healthcare, Zipf, Austria), HDliveFlow with glass-body rendering mode or silhouette mode will facilitate more precise assessments of the fetal heart and peripheral circulation. The resolution of 3D/4D color/power Doppler using the HDlive technique shows a significant improvement compared to conventional 3D/4D color/power Doppler and the fetal heart with great vessels, small peripheral vessels, and placental blood flow can now be clearly recognized. HDliveFlow with glass-body rendering mode or silhouette mode combines the advantages of a spatial view of the great arteries in addition to the visualization of anatomical landmarks, such as the spine or diaphragm. Its use may provide potential advantages in cases of congenital heart anomalies and placental vascularity over the use of conventional 3D/4D color/power Doppler. This novel technique may assist in the evaluation of the fetal cardiovascular system and fetoplacental vascularity, and offer potential advantages relative to conventional 2D color/power Doppler assessments. In this article, we present the latest state-of-the-art HDliveFlow with glass-body rendering mode or silhouette mode of normal and abnormal fetal hearts, placentas, and umbilical cords. We also discuss the present and future applicability of 3D/4D color/ power Doppler to assess the fetal circulation. HDliveFlow with glass-body rendering mode or silhouette mode may become an important modality in future research on fetal cardiac and placental blood flow, and assist in the prenatal diagnosis of fetal congenital heart disease and placental vascular abnormalities. How to cite this article Hata T, AboEllail MAM, Sajapala S, Ito M. HDliveFlow in the Assessment of Fetal Circulation. Donald School J Ultrasound Obstet Gynecol 2015;9(4):462-470.


2020 ◽  
pp. 48-51
Author(s):  
G.A. Ikhtiyarova ◽  
M.J. Aslonova ◽  
N.K. Dustova

The article presents the effectiveness of Dopplerometry for assessing blood flow in large vessels, including the umbilical, uterine artery and middle cerebral artery, 90 women were examined in the second trimester, and 45 women showed signs of placental insufficiency, such as fetal growth restriction syndrome at 28-34 weeks. The results of the study showed that 23 (51.1%) women had signs of subcompensated insufficiency of uteroplacental blood flow, and 11 (24.4%) women showed signs of fetal-placental blood flow. The study of the uteroplacental-fetal blood flow allows early detection of early signs of impairment in the fetoplacental system and its timely correction.


1985 ◽  
Vol 248 (6) ◽  
pp. R698-R701
Author(s):  
S. A. Myers ◽  
H. Y. Tseng

A previous study in pregnant guinea pigs failed to demonstrate any increase in cardiac output when a group of pregnant animals was compared with four nonpregnant animals. In the current study an increase in cardiac output of 35 +/- 14 (SE) ml/min, a 13% increase, was observed during an average 2-wk interval between 44 and 58 days of pregnancy (P less than 0.05, term 68 days, n = 8). A significant increase in placental blood flow of 14.8 +/- 6.2 ml/min (42% increase, P less than 0.05) was also observed during this interval without significant change in the percentage of cardiac output going to the uterus. The data on cardiac output and its distribution to the uteroplacental circulations are consistent with reports in other mammalian species; to accommodate the increased demands of the uteroplacental circulation, cardiac output increases as pregnancy advances. These data demonstrate that multiple observations in the same animal describe cardiac output and its distribution more accurately than a single observation.


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