scholarly journals Prevention of fetal growth restriction in placental insufficiency

2018 ◽  
pp. 27-32
Author(s):  
Z. V. Khachatryan ◽  
N. A. Lomova ◽  
A. A. Khachatryan ◽  
V. L. Tyutyunnik ◽  
N. E. Kan
Keyword(s):  
Blood Flow ◽  
High Risk ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Diagnostic Methods ◽  
Obstetric Complications ◽  
Proinflammatory Mediators

The occurrence and development of such complications of pregnancy as preeclampsia, placental insufficiency, fetal growth restriction can be mediated by the systemic vascular damage. Understanding the pathophysiological mechanisms in the mother-placenta-fetus system contributes to the improvement of diagnostic methods and the selection of pathogenetically valid therapy for certain obstetric complications. In the systemic inflammatory response syndrome accompanying obstetric complications, the uncontrolled and excessive activation of proinflammatory mediators occurs, which leads to generalized tissue damage and development of multiple organ failure.The use of antiplatelet agents at a preventive dose in pregnant women with high risk of placental insufficiency and fetal growth restriction contributes to the reduction of systemic and placental blood flow disorders by affecting the vascular endothelium, increasing the synthesis of prostacyclin and nitric oxide, thereby implementing its angioprotective properties and increasing blood flow in the arteries and existing collaterals.The obtained data showed that adding of dipyridamole to the algorithm for managing pregnant women with high risk of placental insufficiency and fetal growth restriction, starting from the II trimester of gestation allows to reduce the risk of endotheliopathy and thrombophilia, improve obstetric and perinatal outcomes. 

scholarly journals Options of the placental dysfunction correction in women with preeclampsia

2020 ◽  
pp. 111-112
Author(s):  
A.Kh. Karimov ◽  
D.M. Davlietova
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Diagnostic Methods ◽  
Comprehensive Treatment ◽  
Venous Blood Flow ◽  
Social Significance ◽  
Placental Dysfunction

Background. Placental dysfunction (PD) is one of the most common complications of pregnancy, which has not only medical but also social significance. The links of the PD pathogenesis include endothelial dysfunction, hemodynamic disorders of the placental vessels, disorders of arterial and venous blood flow in the placenta. Objective. To study diagnostic methods and possibilities of PD correction in women with preeclampsia (PE). Materials and methods. The study involved 68 women with PE in the II and III trimesters of pregnancy, treated at the multidisciplinary clinic of the Tashkent Medical Academy during 2017-2019. Patients underwent standard clinical, laboratory and instrumental examination with color Doppler mapping of vessels of the uterine-placental-fetal system and ultrasound evaluation of the fetoplacental system. Results and discussion. Premature aging of the placenta was found in 77.3 % of cases, turbid amniotic fluid – in 59.09 %, oligohydramnion – in 27.3 %. Disorders of uteroplacental blood flow were detected in 28.3 % of cases, placentofetal blood flow – in 26.7 %. Impaired blood flow at both levels without critical values occurred in 10 % of pregnant women. In case of insufficiency of a blood circulation of 2nd grade the syndrome of fetal growth restriction was observed in 16,7 % of cases. Compensated forms of PD were subject to the comprehensive treatment with the addition of infusions of L-arginine (Tivortin, “Yuria-Pharm”) in the inpatient phase and oral administration of Tivortin aspartate in the outpatient phase. The length of the fetal thigh in the group of L-arginine at the beginning of treatment was 47.33 mm, which was by 9.04 % less than this parameter in physiological pregnancy. After treatment with Tivortin, in the full-term period, no significant difference was found. In pregnant women who received L-arginine at 25-29 weeks of pregnancy, after 2 weeks, the resistance indices (RI) of the umbilical artery and uterine artery decreased from 0.68±0.09 to 0.58±0.05 and from 0,58±0.16 to 0.43±0.08, respectively. The RI of the middle cerebral artery increased from 1.05±0.23 to 1.27±0.19. Parameters of RI dynamics indicate that the early treatment with Tivortin is more effective than late. Conclusions. 1. Regardless of the presence of fetal growth restriction syndrome in women with disorders of uterine-placental-fetal circulation, it is advisable to include L-arginine in the treatment to prevent this condition. 2. Ultrasound examination is a reliable method for evaluating the effectiveness of PD treatment.

Prediction of fetal growth restriction in high-risk pregnant women

2017 ◽  
Vol 7_2017 ◽  
pp. 34-44 ◽  
Author(s):  
Strizhakov A.N. Strizhakov ◽  
Miryushchenko M.M. Miryushchenko ◽  
Ignatko I.V. Ignatko ◽  
Popova N.G. Popova N ◽  
Florova V.S. Florova ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Growth Restriction

scholarly journals Placental pathology in case of fetal growth restriction - sonographic and morphological indicators of the critical condition

2016 ◽  
Vol 97 (6) ◽  
pp. 869-872 ◽  
Author(s):  
E V Ul’yanina ◽  
N R Akhmadeev ◽  
G R Khayrullina
Keyword(s):  
Blood Flow ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
The State ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Morphological Examination ◽  
Uterine Arteries ◽  
Placental Structure

Aim. To study the peculiarities of placental structure and the state of utero-placental and fetal-placental blood flow in fetal growth restriction.Methods. A prospective study of 50 pregnant women admitted to the department of pathology of pregnancy with fetal growth restriction followed by a retrospective analysis of the obtained data considering risk factors and clinical course of the pregnancy and the results of morphological examination of afterbirth. For the diagnosis of fetal growth restriction ultrasound and Doppler ultrasound of blood flow in the uterine arteries and umbilical artery, and cardiotocography were performed.Results. The most informative sonographic markers of the critical state of the fetus in case of fetal growth restriction are abnormal blood flow indicators of «mother-placenta-fetus» system (critical blood flow disorder in uterine arteries and umbilical artery grade III, blood flow disorder in the medial cerebral artery of the fetus), and also significant hypamnion and changes in placenta combined with poor results of cardiotocography. Obtained data correlated with the results of morphological examination of aftherbirth. Impaired blood flow and significant hypamnion on ultrasound indicate acute placental insufficiency, suggest poor fetal condition, including antenatal death. Petrifaction, infarction and calcification on ultrasound point to chronic placental insufficiency and compensated fetal condition, and they correlate with more favorable perinatal outcomes.Conclusion. The findings of the study demonstrated that ultrasound, Doppler, clinical laboratory and subsequent morphological examination provide very detailed information about the state of placental structure and need for urgent care.

scholarly journals Reflected hemodynamic waves influence the pattern of Doppler ultrasound waveforms along the umbilical arteries

2019 ◽  
Vol 316 (5) ◽  
pp. H1105-H1112 ◽  
Author(s):  
John G. Sled ◽  
Greg Stortz ◽  
Lindsay S. Cahill ◽  
Natasha Milligan ◽  
Viji Ayyathurai ◽  
...  
Keyword(s):  
At Risk ◽  
Blood Flow ◽  
Pregnant Women ◽  
Doppler Ultrasound ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Blood Velocity ◽  
Diagnostic Information ◽  
Growth Restriction

The pulsatile pattern of blood motion measured by Doppler ultrasound within the umbilical artery is known to contain useful diagnostic information and is widely used to monitor pregnancies at risk of fetal growth restriction or stillbirth. Animal studies have identified reflected pressure waves traveling counter to the direction of blood flow as an important factor in the shape of these waveforms. In the present study, we establish a method to measure reflected waves in the human umbilical artery and assess their influence on blood velocity pulsation. Ninety-five pregnant women were recruited from a general obstetrics clinic between 26 and 37 wk of gestation and examined by Doppler ultrasound. Blood velocity waveforms were recorded for each umbilical artery at three locations along the umbilical cord. With the use of a computational procedure, a pair of forward and reverse propagating waves was identified to explain the variation in observed Doppler ultrasound waveforms along the cord. Among the data sets that met data quality requirements, waveforms in 93 of the 130 arteries examined agreed with the wave reflection model to within 1.5% and showed reflections ranging in magnitude from 3 to 52% of the forward wave amplitude. Strong reflections were associated with large differences in pulsatility between the fetal and placental ends of the cord. As reflections arise from transitions in the biomechanical properties of blood vessels, these observations provide a plausible mechanism for the link between abnormal waveforms and clinically significant placental pathology and could lead to more precise screening methods for detecting pregnancies complicated by placental disease.NEW & NOTEWORTHY The pulsatile pattern of blood motion measured by Doppler ultrasound within the umbilical artery is known to contain useful diagnostic information and is widely used to monitor pregnancies at risk of fetal growth restriction. We demonstrate based on a study of 95 pregnant women that the shape of these umbilical artery waveforms is explained by the presence of a reflected pressure wave traveling counter to the direction of blood flow.

Prognostic significance of critical disorders of fetoplacental blood flow in pregnant women with fetal growth restriction

2020 ◽  
Vol 7_2020 ◽  
pp. 129-134
Author(s):  
Kuznetsova N.B. Kuznetsova ◽  
Bushtyreva I.O. Bushtyreva ◽  
Zabanova E.A. Zabanova ◽  
Barinova V.V. Barinova V ◽  
Gugueva A.V. Gugueva ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Prognostic Significance ◽  
Growth Restriction

scholarly journals Changes of the sleep in pregnant women with intrauterine fetal growth restriction

2018 ◽  
Vol 22 (1) ◽  
pp. 160-162
Author(s):  
A.M. Berbets
Keyword(s):  
Pregnant Women ◽  
Sleep Disorders ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Intrauterine Growth Restriction ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Control Group ◽  
Intrauterine Growth ◽  
Intrauterine Fetal Growth Restriction

Objective – to study the reasons of appearance, terms of manifestation and types of the sleep disorders in pregnant women with intrauterine growth restriction of fetus. 80 pregnant women with placental insufficiency, manifesting as intrauterine fetal growth restriction (IUGR) of II–III degree in the 3rd pregnancy trimester (study group) and 30 women with normal clinical flow of pregnancy (control group) were questioned. They were asked about pregnancy term when the complains of the sleep disorders were firstly expressed, as well as about types of the sleep disorders and their frequency (in times per week). Questioning showed that pregnant women with IUGR in 86% cases experience the sleep disorders starting from pregnancy term 12–22 weeks (healthy pregnant women — mostly after 30 weeks, 57% cases), more commonly wake up 2 or more times per night (71% of positive answers, in control group – 23%), and 3 or more times per week (78% of positive answers, in control group – 17%). Thus, sleep disorders in pregnant women with IUGR appear earlier and seem to be more expressed then in pregnant women with normal fetal growth. Expression of the complains of insomnia, in our opinion, might be considered as an early diagnostic sign of forming of placental insufficiency, which is later realized as IUGR.

FETAL GROWTH RESTRICTION WITH EARLY AND LATE MANIFESTATION, PROGNOSTIC MARKERS

2020 ◽  
pp. 27-30
Author(s):  
Yakubova D.I.
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Prenatal Screening ◽  
Prognostic Markers ◽  
Growth Restriction ◽  
Late Manifestation ◽  
Late Form ◽  
Early Manifestation

Objective of the study: Comprehensive assessment of risk factors, the implementation of which leads to FGR with early and late manifestation. To evaluate the results of the first prenatal screening: PAPP-A, B-hCG, made at 11-13 weeks. Materials and Methods: A retrospective study included 110 pregnant women. There were 48 pregnant women with early manifestation of fetal growth restriction, 62 pregnant women with late manifestation among them. Results of the study: The risk factors for the formation of the FGR are established. Statistically significant differences in the indicators between groups were not established in the analyses of structures of extragenital pathology. According to I prenatal screening, there were no statistical differences in levels (PAPP-A, b-hCG) in the early and late form of FGR.

scholarly journals Enhanced Nitrite-Mediated Relaxation of Placental Blood Vessels Exposed to Hypoxia Is Preserved in Pregnancies Complicated by Fetal Growth Restriction

2021 ◽  
Vol 22 (9) ◽  
pp. 4500
Author(s):  
Teresa Tropea ◽  
Carina Nihlen ◽  
Eddie Weitzberg ◽  
Jon O. Lundberg ◽  
Mark Wareing ◽  
...  
Keyword(s):  
Blood Flow ◽  
Blood Vessels ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Plasma Concentrations ◽  
Growth Restriction ◽  
Alternative Source ◽  
Fetal Plasma ◽  
Placental Blood ◽  
Nitrate And Nitrite

Nitric oxide (NO) is essential in the control of fetoplacental vascular tone, maintaining a high flow−low resistance circulation that favors oxygen and nutrient delivery to the fetus. Reduced fetoplacental blood flow is associated with pregnancy complications and is one of the major causes of fetal growth restriction (FGR). The reduction of dietary nitrate to nitrite and subsequently NO may provide an alternative source of NO in vivo. We have previously shown that nitrite induces vasorelaxation in placental blood vessels from normal pregnancies, and that this effect is enhanced under conditions of hypoxia. Herein, we aimed to determine whether nitrite could also act as a vasodilator in FGR. Using wire myography, vasorelaxant effects of nitrite were assessed on pre-constricted chorionic plate arteries (CPAs) and veins (CPVs) from normal and FGR pregnancies under normoxic and hypoxic conditions. Responses to the NO donor, sodium nitroprusside (SNP), were assessed in parallel. Nitrate and nitrite concentrations were measured in fetal plasma. Hypoxia significantly enhanced vasorelaxation to nitrite in FGR CPAs (p < 0.001), and in both normal (p < 0.001) and FGR (p < 0.01) CPVs. Vasorelaxation to SNP was also potentiated by hypoxia in both normal (p < 0.0001) and FGR (p < 0.01) CPVs. However, compared to vessels from normal pregnancies, CPVs from FGR pregnancies showed significantly lower reactivity to SNP (p < 0.01). Fetal plasma concentrations of nitrate and nitrite were not different between normal and FGR pregnancies. Together, these data show that nitrite-mediated vasorelaxation is preserved in FGR, suggesting that interventions targeting this pathway have the potential to improve fetoplacental blood flow in FGR pregnancies.

scholarly journals Aspirin pre-treatment modulates ozone-induced fetal growth restriction and alterations in uterine blood flow in rats

2019 ◽  
Vol 83 ◽  
pp. 63-72 ◽  
Author(s):  
Colette N. Miller ◽  
Urmila P. Kodavanti ◽  
Erica J. Stewart ◽  
Mette Schaldweiler ◽  
Judy H. Richards ◽  
...  
Keyword(s):  
Blood Flow ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Uterine Blood Flow ◽  
Pre Treatment
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