scholarly journals The Relationship between Abnormal Echocardiography Findings in Fetus with Small Gestational Age

2020 ◽  
Vol 10 (1) ◽  
pp. 112
Author(s):  
Kobra Shojaei ◽  
Najmieh Saadati ◽  
Raziye Zarei
Keyword(s):  
Gestational Age ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Fetal Heart ◽  
Fetal Echocardiography ◽  
Pulmonary Arteries ◽  
Growth Restriction ◽  
Common Disease ◽  
Cardiac Abnormalities ◽  
Heart Abnormalities

Background: Intrauterine growth restriction (IUGR), refers to a condition in which the fetus does not grow well according to its genetic potential. Development of the cardiovascular system and impairing fetal developmental planning ultimately caused long-term cardiovascular morbidity. In the present study, the incidence of cardiac abnormalities in fetuses affected by IUGR as well as factors related to the occurrence of these abnormalities were evaluated. Material and Methods: In this descriptive-analytical study, pregnant women referred to the Imam Khomeini Hospital in Ahvaz during February 2018 to January 2020 were recruited. Complete clinical information was recorded using a questionnaire. The recorded information included age, birth weight, gestational age, weight and BMI and comorbidities. Then, echocardiographic data; structural abnormalities including septal condition, valves and outflow of large arteries, and the presence of mass or oxygen in the heart and pulmonary arteries, EF and HR, were extracted from the medical records. Results: In the present study, 152 patients were studied. The mean age of patients was 28.2 ranged from 17- to 40year. Fetal echocardiography showed that nearly 60% of fetuses had heart abnormalities. The most common disease was ventricular septal defect (VSD) (n = 21,13.8%), followed by atrial septal defec(ASD) (n = 15,9.9%) and concurrent ASD and VSD was observed in of 11.2% cases (n = 17). The incidence of echocardiographic abnormalities in IUGR fetuses was significantly higher than in SGA (p = 0.0001). However, the type of IUGR did not have a significant relationship with the incidence of echocardiographic findings in terms of time of performance (Early or late). Among the Doppler ultrasound factors, uterine artery PI (p = 0.001) and umbilical artery PI (p = 0.008) were associated with fetal heart abnormalities. Conclusion: In general, the findings of this study showed that the incidence of heart disorders in IUGR fetuses is high and is related to the severity of fetal growth restriction. Cardiac abnormalities are more common in IUGR fetuses than in SGA. Our results have also shown that the umbilical artery PI and uterine artery PI can be used as predictive factors in diagnosing fetal heart abnormalities. Our findings suggest an evaluation of echocardiography in IUGR fetuses.

scholarly journals Hemodynamic factors associated with fetal cardiac remodeling in late fetal growth restriction: a prospective study

2019 ◽  
Vol 47 (7) ◽  
pp. 683-688
Author(s):  
Giuseppe Rizzo ◽  
Cecilia Mattioli ◽  
Ilenia Mappa ◽  
Victoria Bitsadze ◽  
Jamilya Khizroeva ◽  
...  
Keyword(s):  
Prospective Study ◽  
Cardiac Remodeling ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Umbilical Vein ◽  
Growth Restriction ◽  
Cardiac Remodelling ◽  
Special Care Unit ◽  
Factors Associated ◽  
A Prospective Study

Abstract Background Altered cardiac geometry affects a proportion of fetuses with growth restriction (FGR). The aim of this study was to explore the hemodynamic factors associated with cardiac remodeling in late FGR. Methods This was a prospective study of singleton pregnancies complicated by late-onset FGR undergoing assessment of left (LV) and right (RV) ventricular sphericity-index (SI). The study population was divided in two groups according to the presence of cardiac remodelling, defined as LVSI <5th centile. The following outcomes were explored: gestational age at birth, birthweight, caesarean section (CS) for fetal distress, umbilical artery (UA) pH and neonatal admission to special care unit. The differences between the 2 groups in UA pulsatility index (PI), middle cerebral artery (MCA) PI, uterine artery PI, cerebroplacental ratio (CPR) and umbilical vein (UV) flow corrected for fetal abdominal circumference (UVBF/AC) were tested. Results In total, 212 pregnancies with late FGR were enrolled in the study. An abnormal LV SI was detected in 119 fetuses (56.1%). Late FGR fetuses with cardiac remodeling had a lower birthweight (2390 g vs. 2490; P = 0.04) and umbilical artery pH (7.21 vs. 7.24; P = 0.04) and were more likely to have emergency CS (42.8% vs. 26.9%; P = 0.023) and admission to special care unit (13.4% vs. 4.3%; P = 0.03) compared to those with normal LVSI. No difference in either UA PI (p = 0.904), MCA PI (P = 0.575), CPR (P = 0.607) and mean uterine artery PI (P = 0.756) were present between fetuses with or without an abnormal LV SI. Conversely, UVBF/AC z-score was lower (−1.84 vs. −0.99; P ≤ 0.001) in fetuses with cardiac remodeling and correlated with LV (P ≤ 0.01) and RV SI (P ≤ 0.02). Conclusion Fetal cardiac remodelling occurs in a significant proportion of pregnancies complicated by late FGR and is affected by a high burden of short-term perinatal compromise. The occurrence of LV SI is independent from fetal arterial Dopplers while it is positively associated with umbilical vein blood flow.

scholarly journals Early Uterine and Umbilical Artery Doppler Indices as Predictor for Preeclampsia and Intrauterine Growth Restriction

2021 ◽  
pp. 116-126
Author(s):  
Sara E. Khalil ◽  
Mohammed M. Elnamory ◽  
Mona K. omar ◽  
Hesham M. Eltokhy
Keyword(s):  
Gestational Age ◽  
Predictive Value ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Doppler Study ◽  
Significant Difference ◽  
Umbilical Artery Doppler ◽  
Doppler Indices

Background: Preeclampsia (PE) is a disorder that causes hypertension and proteinuria after week 20 of pregnancy. Several Uterine Artery (UtAs) Doppler characteristics have been investigated for their ability to predict PE. The purpose of this research is to look into the uterine and umbilical arterial Doppler indices in the early second trimester for the prediction of late preeclampsia or intrauterine growth restriction. Methods: This is a prospective cohort clinical study and was done at Obstetrics and Gynecology department, faculty of medicine Tanta university hospital from January 2020 till April 2021. 150 pregnant women aged from 18 to 30 years old with gestational age from 13 to 16 weeks of pregnancy. Study was done by the same observer by machine MINDRAY DC60 Measurement of fetal biometry (BPD, FL, AC, HC) Gestational age was confirmed with Detection of congenital malformation.    Results: There is a significant difference between the groups regarding uterine and umbilical artery doppler Indices. Uterine RI only yielded significance for predicting IUGR with sensitivity of 62% and specificity of 88%, with Positive predictive value (PPV) 37% and Negative predictive value (NPV) 92%. Umbilical resistance index achieved sensitivity of 56% and specificity of 82%, with PPV 31% and NPV 30% with on statistical significance. Conclusions: Combination of uterine and umbilical artery Doppler study in early pregnancy is one of the best indicator for prediction of preeclampsia and IUGR. Therefore, Doppler study may be used for the prediction of preeclampsia and IUGR to reduce the maternal and perinatal morbidity and mortality.

scholarly journals Solcoseryl versus Low Molecular Weighte Heparin for Intrauterine Fetal Growth Restriction

2021 ◽  
pp. 215-228
Author(s):  
Samar M. Abd El-Razek ◽  
Mohammed M. Elnamory ◽  
Mona K. Omar ◽  
Hesham M. Eltokhy
Keyword(s):  
Birth Weight ◽  
Fetal Growth ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Once Daily ◽  
Group A ◽  
Group B ◽  
Doppler Indices

Background: FETAL Growth Restriction (FGR) is a problem where the fetus fails to attain its normal growth potential and this affects nearly about 8% of all pregnancies Solcoseryl is a protein-free and antigen-free haemodialysate derived from calf blood. It is thought to activate the cellular respiratory chain leading to better oxygen utilisation by the tissues. Aim of the study was to compare between Solcoseryl and low molecular weight heparin in treatment of patients suffered from intrauterine growth restriction due to placental insufficiency. Methods: The patients who included in this study were divided randomly via (computer-generated random numeric tables prepared by a statistician) into two groups with 35 cases in each group. Group (A) (Solcoseryl. Group): 35 women received Solcoseryl ampule 42.5 mg intravenous infusion (Misr Compony) Once daily for 3 weeks. Group (B) (LMWH (Clexan) Group): 35 women received single dose of LMWH subcutaneous (clexane 40 mg) once daily for 3 weeks. Results: There is a significant decrease regarding umbilical artery RI in both groups but the significant decrease was better in group A compared to group B. Otherwise, there is no significant difference between the two groups umbilical artery RI at different time intervals. there is significant increase in Gestational age and birth weight in patients who receive solcoseryl and LMWH .There is an improvement in Doppler indices of both (UA and MCA) in  both group but is better in solcoseryl than LMWH and significant increase  in Apgar score at 1min and 5 min in both groups but is better in solcoseryl than LMWH. Conclusions: In this study, LMWH and Solcoseryl administration in IUGR fetuses enhance Doppler indices, promote significant increase in Gestational age so enhance neonatal birth weight.

scholarly journals Задержка (замедление) роста плода: современные принципы диагностики, классификации и динамического наблюдения

2019 ◽  
pp. 33-44
Keyword(s):  
Doppler Ultrasound ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Cerebroplacental Ratio

В статье детально представлены унифицированные критерии диагностики задержки (замедления) роста плода, выработанные в 2016 г. ведущими мировыми экспертами и рекомендованные к применению в клинической и научной работе. Обсуждается современный подход к анализу допплерометрических параметров кровотока в системе “мать-плацентаплод”, включая расчет церебральноплацентар ного отношения. Приводятся международные принципы обследования беременных с задержкой роста плода, протоколы и алгоритмы дальнейшего наблюдения, выбора срока и метода родоразрешения, разработанные на основании доказательных многоцентровых европейских исследований. Ключевые слова: задержка (замедление) роста плода, церебрально-плацентарное отношение, артерия пуповины, маточная артерия, венозный проток, плацентарная недостаточность, ультразвуковое допплеровское исследование, fetal growth restriction, cerebroplacental ratio, umbilical artery, uterine artery, ductus venosus, placental insufficiency, Doppler ultrasound

Melatonin supplementation alters uteroplacental hemodynamics and fetal development in an ovine model of intrauterine growth restriction

2012 ◽  
Vol 302 (4) ◽  
pp. R454-R467 ◽  
Author(s):  
Caleb O. Lemley ◽  
Allison M. Meyer ◽  
Leticia E. Camacho ◽  
Tammi L. Neville ◽  
David J. Newman ◽  
...  
Keyword(s):  
Blood Flow ◽  
Fetal Growth ◽  
Intrauterine Growth Restriction ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Artery Blood Flow ◽  
Ovine Model ◽  
Melatonin Treatment ◽  
Intrauterine Growth

Using a mid- to late-gestation ovine model of intrauterine growth restriction (IUGR), we examined uteroplacental blood flow and fetal growth during melatonin supplementation as a 2 × 2 factorial design. At day 50 of gestation, 32 ewes were supplemented with 5 mg of melatonin (MEL) or no melatonin (CON) and were allocated to receive 100% [adequate; (ADQ)] or 60% [restricted (RES)] of nutrient requirements until day 130 of gestation. Umbilical artery blood flow was increased from day 60 to day 110 of gestation in MEL vs. CON dams, while umbilical artery blood flow was decreased from day 80 to day 110 of gestation in RES vs. ADQ dams. At day 130 of gestation, uteroplacental hemodynamics, measured under general anesthesia, and fetal growth were evaluated. Uterine artery blood flow was decreased in RES vs. ADQ dams, while melatonin supplementation did not affect uterine artery blood flow. Total placentome weight and placentome number were not different between treatment groups. Fetal weight was decreased by nutrient restriction. Abdominal girth and ponderal index were increased in fetuses from MEL-ADQ dams vs. all other groups. Fetal biparietal distance was decreased in CON-RES vs. CON-ADQ dams, while melatonin supplementation rescued fetal biparietal distance. Fetal kidney length and width were increased by maternal melatonin treatment. Fetal cardiomyocyte area was altered by both maternal melatonin treatment and nutritional plane. In summary, melatonin may negate the consequences of IUGR during specific abnormalities in umbilical blood flow as long as sufficient uterine blood perfusion is maintained during pregnancy.

scholarly journals Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction

2018 ◽  
Vol 40 (05) ◽  
pp. 287-293 ◽  
Author(s):  
Marianna Pedroso ◽  
Kirsten Palmer ◽  
Ryan Hodges ◽  
Fabricio Costa ◽  
Daniel Rolnik
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Growth Restriction ◽  
Uterine Artery ◽  
Growth Restriction ◽  
Current Evidence ◽  
Individual Risk ◽  
Predictive Test ◽  
Uterine Artery Doppler

Objective To perform a comprehensive review of the current evidence on the role of uterine artery Doppler, isolated or in combination with other markers, in screening for preeclampsia (PE) and fetal growth restriction (FGR) in the general population. The review included recently published large cohort studies and randomized trials. Methods A search of the literature was conducted using Medline, PubMed, MeSH and ScienceDirect. Combinations of the search terms “preeclampsia,” “screening,” “prediction,” “Doppler,” “Doppler velocimetry,” “fetal growth restriction,” “small for gestational age” and “uterine artery” were used. Articles in English (excluding reviews) reporting the use of uterine artery Doppler in screening for PE and FGR were included. Results Thirty articles were included. As a single predictor, uterine artery Doppler detects less than 50% of the cases of PE and no more than 40% of the pregnancies affected by FGR. Logistic regression-based models that allow calculation of individual risk based on the combination of multiple markers, in turn, is able to detect ∼ 75% of the cases of preterm PE and 55% of the pregnancies resulting in small for gestational age infants. Conclusion The use of uterine artery Doppler as a single predictive test for PE and FGR has poor accuracy. However, its combined use in predictive models is promising, being more accurate in detecting preterm PE than FGR.

scholarly journals Doppler predictors of perinatal outcome in intra-uterine growth retarded foetuses

2019 ◽  
Vol 8 (11) ◽  
pp. 4298
Author(s):  
Varshika Mahesh Hingorani ◽  
Dharita S. Shah ◽  
Madhura Ghate ◽  
Sachin Patel
Keyword(s):  
Gestational Age ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Outcome Data ◽  
Doppler Velocity ◽  
Positive Pressure ◽  
Pregnancy Induced Hypertension ◽  
Perinatal Complications ◽  
Average Birth Weight ◽  
Induced Hypertension

Background: The study aims at early detection of intrauterine growth retarded fetuses which are at high risk of perinatal complications. It can help obstetricians take appropriate preventive steps and prevent serious perinatal complications.Methods: The study undertaken over 100 pregnant women with pregnancy induced hypertension between 28-36 weeks subjected to umbilical artery and uterine artery doppler. The outcome data including gestational age at birth, birth height, APGAR score, admission to NICU, need for positive pressure ventilation and neonatal mortality.Results: The study shows that 58% mothers with IUGR foetuses were primigravida; gestational age at delivery is 34.2 weeks and 82% of IUGR foetuses were delivered by C-section. Average birth weight of foetus with abnormal doppler was significantly lower and there was high incidence of NICU admission. The study also shows that oligohydroamnios was common with abnormal doppler group.Conclusions: Umbilical artery doppler velocity in addition to uterine artery velocity doppler should be considered as a primary tool for foetal surveillance in pregnancy induced hypertension patients and for planning management of IUGR foetuses.

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