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- Title
Retrograde net blood flow in the aortic isthmus in relation to human fetal arterial and venous circulations.
- Authors
Mäkikallio, K.; Jouppila, P.; Räsänen, J.
- Abstract
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.
- Subjects
FETAL abnormalities; BLOOD flow; HUMAN abnormalities; PLACENTA
- Publication
Ultrasound in Obstetrics & Gynecology, 2002, Vol 19, Issue 2, p147
- ISSN
0960-7692
- Publication type
Article
- DOI
10.1046/j.0960-7692.2001.00626.x