| Fetal hemodynamic development of macrosomic growth. | |
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MedLine Citation:
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PMID: 21557374 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the venous and arterial hemodynamics underlying macrosomic fetal growth. METHODS: Of 58 healthy women who previously had given birth to a large neonate and were therefore included in the prospective longitudinal study, 29 gave birth to neonates with birth weight >90(th) percentile and were included in the statistics. Umbilical vein blood flow and Doppler measurements of the ductus venosus, left portal vein, and the hepatic, splenic, superior mesenteric, cerebral and umbilical arteries were repeated during the second half of pregnancy and compared with the corresponding reference values. Ultrasound biometry was used to estimate fetal weight. RESULTS: Umbilical blood flow increased faster in macrosomic fetuses, showed less blunting near term and was also significantly higher when normalised for fetal weight (p<0.0001). The porto-caval perfusion pressure of the liver (expressed by the ductus venosus systolic blood velocity) and the left portal vein blood velocity (expressing umbilical venous distribution to the right liver lobe) were significantly higher. Systolic velocity was higher in the splenic, superior mesenteric, cerebral and umbilical arteries, while the pulsatility index was unaltered in the cerebral, hepatic, splenic and mesenteric arteries, but lower in the umbilical artery. CONCLUSION: There is an augmented umbilical flow in macrosomic fetuses particularly near term, also when normalised for fetal weight, providing increased liver perfusion including the right liver lobe. Signs of increased vascular cross section and flow are also seen on the arterial side but not expressed in the pulsatility index of organs with prominent auto-regulation (i.e. brain, liver, spleen and gut). Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. |
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Authors:
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Cathrine Ebbing; Svein Rasmussen; Torvid Kiserud |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-9 |
Journal Detail:
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Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: - ISSN: 1469-0705 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-5-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. |
Affiliation:
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Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Norway. cathrine.ebbing@molmed.uib.no. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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