Retrograde net blood flow in the aortic isthmus in relation to human fetal arterial and venous circulations

K. Mäkikallio, P. Jouppila, Juha Rasanen

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Objectives: To characterize changes in the human fetal arterial and venous circulations associated with retrograde aortic isthmus net blood flow. Methods: Study groups consisted of fetuses with placental insufficiency and/or fetal growth restriction and either antegrade (Group 1; n = 18) or retrograde (Group 2; n = 11) net blood flow in the aortic isthmus. The control group comprised 31 fetuses in uncomplicated pregnancies. Pulsatility indices of the umbilical, middle cerebral and proximal pulmonary arteries and the descending aorta, and pulsatility indices for veins of the ductus venosus and inferior vena cava were calculated. Right and left ventricular fractional shortenings were ascertained. The coronary artery blood flow was visualized and the presence of tricuspid regurgitation was noted. Results: In the study groups, the umbilical artery and descending aorta pulsatility indices were significantly higher (P <0.05), and those of the middle cerebral artery lower (P <0.001), than in the control group, with no difference between the two study groups. The proximal pulmonary artery pulsatility index was significantly higher in Group 2 (P <0.001) than in Group 1 and the control group. In Group 2, the right ventricular fractional shortening was significantly lower (P <0.01) than in Group 1. Coronary artery blood flow was visualized significantly more often (P <0.03) and tricuspid regurgitation was present more frequently (P <0.003) in Group 2 than in Group 1. In Group 2, the ductus venosus pulsatility index for veins was significantly higher than in Group 1 (P <0.01) and the control group (P <0.01), with no difference in the inferior vena cava pulsatility index for veins. Conclusions: Fetuses with retrograde aortic isthmus net blood flow demonstrate a rise in right ventricular afterload and increased pulsatility in ductus venosus blood velocity waveforms.

Original languageEnglish (US)
Pages (from-to)147-152
Number of pages6
JournalUltrasound in Obstetrics and Gynecology
Volume19
Issue number2
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

isthmuses
blood flow
Veins
Tricuspid Valve Insufficiency
Control Groups
Fetus
Inferior Vena Cava
arteries
Thoracic Aorta
Pulmonary Artery
Coronary Vessels
Placental Insufficiency
Umbilicus
Umbilical Arteries
fetuses
Middle Cerebral Artery
veins
Fetal Development
aorta
Pregnancy

Keywords

  • Doppler
  • Fetal heart
  • Hemodynamics
  • Physiology
  • Placental insufficiency

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Acoustics and Ultrasonics

Cite this

Retrograde net blood flow in the aortic isthmus in relation to human fetal arterial and venous circulations. / Mäkikallio, K.; Jouppila, P.; Rasanen, Juha.

In: Ultrasound in Obstetrics and Gynecology, Vol. 19, No. 2, 2002, p. 147-152.

Research output: Contribution to journalArticle

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abstract = "Objectives: To characterize changes in the human fetal arterial and venous circulations associated with retrograde aortic isthmus net blood flow. Methods: Study groups consisted of fetuses with placental insufficiency and/or fetal growth restriction and either antegrade (Group 1; n = 18) or retrograde (Group 2; n = 11) net blood flow in the aortic isthmus. The control group comprised 31 fetuses in uncomplicated pregnancies. Pulsatility indices of the umbilical, middle cerebral and proximal pulmonary arteries and the descending aorta, and pulsatility indices for veins of the ductus venosus and inferior vena cava were calculated. Right and left ventricular fractional shortenings were ascertained. The coronary artery blood flow was visualized and the presence of tricuspid regurgitation was noted. Results: In the study groups, the umbilical artery and descending aorta pulsatility indices were significantly higher (P <0.05), and those of the middle cerebral artery lower (P <0.001), than in the control group, with no difference between the two study groups. The proximal pulmonary artery pulsatility index was significantly higher in Group 2 (P <0.001) than in Group 1 and the control group. In Group 2, the right ventricular fractional shortening was significantly lower (P <0.01) than in Group 1. Coronary artery blood flow was visualized significantly more often (P <0.03) and tricuspid regurgitation was present more frequently (P <0.003) in Group 2 than in Group 1. In Group 2, the ductus venosus pulsatility index for veins was significantly higher than in Group 1 (P <0.01) and the control group (P <0.01), with no difference in the inferior vena cava pulsatility index for veins. Conclusions: Fetuses with retrograde aortic isthmus net blood flow demonstrate a rise in right ventricular afterload and increased pulsatility in ductus venosus blood velocity waveforms.",
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N2 - Objectives: To characterize changes in the human fetal arterial and venous circulations associated with retrograde aortic isthmus net blood flow. Methods: Study groups consisted of fetuses with placental insufficiency and/or fetal growth restriction and either antegrade (Group 1; n = 18) or retrograde (Group 2; n = 11) net blood flow in the aortic isthmus. The control group comprised 31 fetuses in uncomplicated pregnancies. Pulsatility indices of the umbilical, middle cerebral and proximal pulmonary arteries and the descending aorta, and pulsatility indices for veins of the ductus venosus and inferior vena cava were calculated. Right and left ventricular fractional shortenings were ascertained. The coronary artery blood flow was visualized and the presence of tricuspid regurgitation was noted. Results: In the study groups, the umbilical artery and descending aorta pulsatility indices were significantly higher (P <0.05), and those of the middle cerebral artery lower (P <0.001), than in the control group, with no difference between the two study groups. The proximal pulmonary artery pulsatility index was significantly higher in Group 2 (P <0.001) than in Group 1 and the control group. In Group 2, the right ventricular fractional shortening was significantly lower (P <0.01) than in Group 1. Coronary artery blood flow was visualized significantly more often (P <0.03) and tricuspid regurgitation was present more frequently (P <0.003) in Group 2 than in Group 1. In Group 2, the ductus venosus pulsatility index for veins was significantly higher than in Group 1 (P <0.01) and the control group (P <0.01), with no difference in the inferior vena cava pulsatility index for veins. Conclusions: Fetuses with retrograde aortic isthmus net blood flow demonstrate a rise in right ventricular afterload and increased pulsatility in ductus venosus blood velocity waveforms.

AB - Objectives: To characterize changes in the human fetal arterial and venous circulations associated with retrograde aortic isthmus net blood flow. Methods: Study groups consisted of fetuses with placental insufficiency and/or fetal growth restriction and either antegrade (Group 1; n = 18) or retrograde (Group 2; n = 11) net blood flow in the aortic isthmus. The control group comprised 31 fetuses in uncomplicated pregnancies. Pulsatility indices of the umbilical, middle cerebral and proximal pulmonary arteries and the descending aorta, and pulsatility indices for veins of the ductus venosus and inferior vena cava were calculated. Right and left ventricular fractional shortenings were ascertained. The coronary artery blood flow was visualized and the presence of tricuspid regurgitation was noted. Results: In the study groups, the umbilical artery and descending aorta pulsatility indices were significantly higher (P <0.05), and those of the middle cerebral artery lower (P <0.001), than in the control group, with no difference between the two study groups. The proximal pulmonary artery pulsatility index was significantly higher in Group 2 (P <0.001) than in Group 1 and the control group. In Group 2, the right ventricular fractional shortening was significantly lower (P <0.01) than in Group 1. Coronary artery blood flow was visualized significantly more often (P <0.03) and tricuspid regurgitation was present more frequently (P <0.003) in Group 2 than in Group 1. In Group 2, the ductus venosus pulsatility index for veins was significantly higher than in Group 1 (P <0.01) and the control group (P <0.01), with no difference in the inferior vena cava pulsatility index for veins. Conclusions: Fetuses with retrograde aortic isthmus net blood flow demonstrate a rise in right ventricular afterload and increased pulsatility in ductus venosus blood velocity waveforms.

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KW - Hemodynamics

KW - Physiology

KW - Placental insufficiency

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