Doppler Ultrasound of the Fetal Descending Aorta: An Objective Tool to Assess Placental Blood Flow Resistance in Pregnancies With Discordant Umbilical Arteries.


Journal

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
ISSN: 1550-9613
Titre abrégé: J Ultrasound Med
Pays: England
ID NLM: 8211547

Informations de publication

Date de publication:
Apr 2022
Historique:
revised: 10 06 2021
received: 27 04 2021
accepted: 20 06 2021
pubmed: 7 7 2021
medline: 16 3 2022
entrez: 6 7 2021
Statut: ppublish

Résumé

To determine the relationship between blood flow in the fetal descending aorta and discordant umbilical arteries (UAs). Pulsed wave Doppler of both UAs and the descending aorta was performed at 4-weekly intervals between 14 and 40 weeks of gestation in 209 pregnant women. In datasets with discordant UAs, a linear mixed effects model was used to determine the categorical relationship between the UA pulsatility index (PI) (high, low and average) and the descending aorta PI. Of the 209 cases, 81 had a discordance of greater than 25% in UA PI during one of their visits. There were no differences in birth outcomes between the groups with concordant and discordant UA PIs. In the cases with discordant UA PIs, the descending aorta PI was most strongly associated with both the average UA PI (P = .008), and with the UA with the lower PI (P = .008). The relationship between blood flow in the descending aorta and UAs is consistent with the law for combining resistances in parallel. Measurements of the descending aorta PI, particularly in a scenario with discordant UAs, may inform the stability of the feto-placental circulation where discordant UA PIs are found.

Identifiants

pubmed: 34228375
doi: 10.1002/jum.15773
pmc: PMC8733057
mid: NIHMS1762446
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

899-905

Subventions

Organisme : NICHD NIH HHS
ID : U01 HD087177
Pays : United States
Organisme : Banting Research Foundation
Organisme : Eunice Kennedy Shriver National Institute of Child Health and Human Development
ID : 1U01HD087177-01

Informations de copyright

© 2021 American Institute of Ultrasound in Medicine.

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Auteurs

Lindsay S Cahill (LS)

Department of Chemistry, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada.

Grace V Mercer (GV)

Department of Chemistry, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada.

Dakshita Jagota (D)

Department of Chemistry, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada.

Anjana Ravi Chandran (A)

Mount Sinai Hospital, Toronto, Ontario, Canada.

Natasha Milligan (N)

Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.

Shiri Shinar (S)

Mount Sinai Hospital, Toronto, Ontario, Canada.

Clare L Whitehead (CL)

Pregnancy Research Centre, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville, Australia.

Sebastian R Hobson (SR)

Mount Sinai Hospital, Toronto, Ontario, Canada.

Lena Serghides (L)

Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.
Department of Immunology and Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.
Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.

W Tony Parks (WT)

Department of Pathology, Mount Sinai Hospital, Toronto, Ontario, Canada.
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.

Christopher K Macgowan (CK)

Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.

John C Kingdom (JC)

Mount Sinai Hospital, Toronto, Ontario, Canada.
Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.

John G Sled (JG)

Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.

Ahmet A Baschat (AA)

Centre for Fetal Therapy, Johns Hopkins Medicine, Baltimore, Maryland, USA.

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