Document Detail


Ductus venosus velocimetry in acute fetal acidemia and impending fetal death in a sheep model of increased placental vascular resistance.
MedLine Citation:
PMID:  20097769     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We investigated whether hypoxemia without acidemia affects ductus venosus (DV) blood velocity waveform pattern in sheep fetuses with intact placenta and whether worsening acidemia and impending fetal death are related to changes in DV velocimetry in fetuses with increased placental vascular resistance. A total of 34 fetuses were instrumented at 115-136/145 days of gestation. Placental embolization was performed in 22 fetuses on the fourth postoperative day, 24 h before the experiment. The control group was comprised of 12 fetuses with intact placenta. The experimental protocol consisted of fetal hypoxemia that was induced by replacing maternal inhaled oxygen with medical air. To further deteriorate fetal oxygenation and blood-gas status, uterine artery volume blood flow was reduced by maternal hypotension. Fetuses that underwent placental embolization were divided into two groups according to fetal outcome. Group 1 consisted of 12 fetuses that completed the experiment, and group 2 comprised 10 fetuses that died during the experiment. DV pulsatility index for veins (PIV) and fetal cardiac outputs (COs) were calculated. Placental volume blood flow, fetal blood pressures, and acid base and lactate values were monitored invasively. On the experimental day, the mean gestational age did not differ significantly between the groups. In groups 1 and 2, the baseline mean DV PIV and fetal COs were not statistically significantly different from the control group. In the control group, the DV PIV values increased significantly with hypoxemia. In groups 1 and 2, the DV PIV values did not change significantly, even with worsening acidemia and imminent fetal death in group 2. During the experiment, the fetal COs remained unchanged. We conclude that fetal hypoxemia increases the pulsatility of DV blood velocity waveform pattern. In fetuses with elevated placental vascular resistance, DV pulsatility does not increase further in the presence of severe and worsening fetal acidemia and impending fetal death.
Authors:
Kaarin M?kikallio; Ganesh Acharya; Tiina Erkinaro; Tomi Kavasmaa; Mervi Haapsamo; James C Huhta; Juha R?s?nen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-22
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  298     ISSN:  1522-1539     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-22     Completed Date:  2010-04-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H1229-34     Citation Subset:  IM    
Affiliation:
Dept. of Obstetrics and Gynecology, University of Oulu, Finland.
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MeSH Terms
Descriptor/Qualifier:
Animals
Anoxia / physiopathology
Blood Flow Velocity / physiology
Blood Pressure / physiology
Fatty Acids / blood*
Female
Fetal Death / physiopathology*
Fetus / blood supply*
Heart Rate / physiology
Models, Animal
Placenta / blood supply*
Pregnancy
Regional Blood Flow / physiology
Sheep
Umbilical Veins / embryology
Vascular Resistance / physiology*
Veins / physiology*
Vena Cava, Inferior / embryology
Chemical
Reg. No./Substance:
0/Fatty Acids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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