| The fetal aortic pressure pulse waveform in normal and compromised pregnancy. | |
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MedLine Citation:
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PMID: 9386025 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To study the arterial pressure waveform in the descending thoracic aorta during pregnancy in both normal and compromised fetuses. DESIGN: The pressure pulsation waveform propagated along the vascular tree, and acting laterally on the arterial wall, produces a corresponding change in the vessel diameter. The distance between diametrically opposite points of the aortic lumen was followed using a phase locked loop echo tracking system coupled to a B-mode ultrasonic imager (central frequency 3.5 MHz). SETTING: Tertiary referral unit, teaching hospital. PARTICIPANTS: A cross-sectional study of 80 normal fetuses between 20 and 40 weeks yielded normal data. We studied 58 women with evidence of potential fetal compromise (high umbilical artery systolic: diastolic ratio). MAIN OUTCOME MEASURES: From the aortic diameter waveform we measured the maximum systolic and minimum diastolic dimension and calculated pulse amplitude. The first derivative of the aortic diameter waveform identified the incisura of aortic and pulmonary valve closure and was used to time the end of ventricular ejection and systole. RESULTS: In normal pregnancy there was an increase in systolic and diastolic diameter and pulse amplitude with advancing gestation. Ventricular ejection time was constant. In the fetal compromised group the absolute systolic and diastolic diameters were within the normal range, but diastolic diameter per unit fetal weight was increased. There was a decrease in pulse amplitude as a percentage of diastolic diameter and an increase in the diastolic systolic diameter ratio. Fetal outcome was examined in relation to the diastolic systolic diameter ratio. Those with a high ratio (above 90th centile of normal group) exhibited significantly more adverse indices of fetal outcome. CONCLUSIONS: The fetal aortic pressure pulse waveform was represented by the vessel diameter waveform. In fetal compromise reduced pulse amplitude and increased diastolic to systolic diameter ratio suggest corresponding changes in arterial pressure pulse. We suggest these are the response of the cardiac pump to increased afterload imposed by the high umbilical placental vascular resistance. |
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Authors:
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A Mori; B Trudinger; R Mori; V Reed; Y Takeda |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: British journal of obstetrics and gynaecology Volume: 104 ISSN: 0306-5456 ISO Abbreviation: Br J Obstet Gynaecol Publication Date: 1997 Nov |
Date Detail:
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Created Date: 1997-12-23 Completed Date: 1997-12-23 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7503752 Medline TA: Br J Obstet Gynaecol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 1255-61 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynaecology, University of Sydney at Westmead Hospital, New South Wales, Australia. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aorta, Thoracic
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embryology,
physiology* Blood Pressure / physiology* Cross-Sectional Studies Female Fetal Diseases / physiopathology* Gestational Age Humans Placental Insufficiency / physiopathology* Pregnancy Ultrasonography, Prenatal |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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