Document Detail

Fetal aortic blood flow assessment from the relationship between fetal aortic diameter pulse and flow velocity waveforms during fetal development.
MedLine Citation:
PMID:  11520629     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Blood flow is calculated from mean velocity across the vessel and its cross-sectional area and is related to the fetal growth. AIM: To investigate the relationship between diameter pulse waveform (DPW) and flow velocity waveform (FVW) in the fetal descending aorta during fetal development. STUDY DESIGN: Doppler ultrasound and a phase-locked loop echo tracking system were used to measure the FVW and DPW in the fetal descending aorta, respectively. SUBJECTS: We studied 137 normal-growth fetuses (normal group, 20-40 weeks) and 51 fetuses with high umbilical artery pulsatility index (umbilical placental insufficiency, UPI group, 26-40 weeks). OUTCOME MEASURES: We measured the systolic (Sd), diastolic (Dd) diameters, time diameter integral (TDI) and time velocity integral (TVI) and then calculated the TVI x TDI and TVI to TDI ratio. RESULTS: Normal fetal growth was associated with an increase in Sd, Dd, pulse amplitude, TVI, TDI and TVI x TDI. The FVW began to resemble the DPW with decreasing downstream resistance produced by growth of the placenta. The TVI was increased relative to the TDI. The differences in Sd, Dd, TDI and TVI x TDI between the normal and UPI groups were not significant. The TVI was decreased relative to the TDI. There was a decrease in the TVI as a ratio of the TDI. The Dd per unit fetal weight was high in the compromised fetuses. Fetal outcome was examined in relation to the TVI to TDI ratio. Those with a low ratio (below 10th centile) exhibited significantly more adverse indices of fetal outcome. CONCLUSIONS: In fetal compromise there is an increase in diastolic pressure in association with high placental resistance, which causes a major increase in afterload. The efficient circulation associated with fetal growth might be represented by an increase in the ratio of the TVI to the TDI (an index of efficient circulation) when these waveform shapes resemble each other.
Y Saburi; A Mori; I Yasui; T Makino; M Iwabuchi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Early human development     Volume:  65     ISSN:  0378-3782     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-08-24     Completed Date:  2001-10-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  57-70     Citation Subset:  IM    
Department of Obstetric and Gynecology, Tokai University School of Medicine, Boseidai, Isehara, Kanagawa 259-1193, Japan.
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MeSH Terms
Aorta, Thoracic / embryology*,  physiology,  ultrasonography
Blood Flow Velocity / physiology
Blood Pressure / physiology
Embryonic and Fetal Development / physiology*
Fetus / blood supply,  physiology*
Placental Insufficiency / physiopathology
Pregnancy / physiology*
Pulsatile Flow / physiology
Ultrasonography, Doppler
Ultrasonography, Prenatal

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