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Maternal cardiovascular dysfunction is associated with hypoxic cerebral and umbilical doppler changes

Title: Maternal cardiovascular dysfunction is associated with hypoxic cerebral and umbilical doppler changes
Authors: Masini, G
Tay, J
McEniery, CM
Wilkinson, IB
Valensise, H
Tiralongo, GM
Farsetti, D
Gyselaers, W
Vonck, S
Lees, CC
Item Type: Journal Article
Abstract: We investigate the relationship between maternal cardiovascular (CV) function and fetal Doppler changes in healthy pregnancies and those with pre-eclampsia (PE), small for gestational age (SGA) or fetal growth restriction (FGR). This was a three-centre prospective study, where CV assessment was performed using inert gas rebreathing, continuous Doppler or impedance cardiography. Maternal cardiac output (CO) and peripheral vascular resistance (PVR) were analysed in relation to the uterine artery, umbilical artery (UA) and middle cerebral artery (MCA) pulsatility indices (PI, expressed as z-scores by gestational week) using polynomial regression analyses, and in relation to the presence of absent/reversed end diastolic (ARED) flow in the UA. We included 81 healthy controls, 47 women with PE, 65 with SGA/FGR and 40 with PE + SGA/FGR. Maternal CO was inversely related to fetal UA PI and positively related to MCA PI; the opposite was observed for PVR, which was also positively associated with increased uterine artery impedance. CO was lower (z-score 97, p = 0.02) and PVR higher (z-score 2.88, p = 0.02) with UA ARED flow. We report that maternal CV dysfunction is associated with fetal vascular changes, namely raised impedance in the fetal-placental circulation and low impedance in the fetal cerebral vessels. These findings are most evident with critical UA Doppler changes and represent a potential mechanism for therapeutic intervention.
Issue Date: 7-Sep-2020
Date of Acceptance: 2-Sep-2020
URI: http://hdl.handle.net/10044/1/91079
DOI: 10.3390/jcm9092891
ISSN: 2077-0383
Publisher: MDPI AG
Start Page: 1
End Page: 10
Journal / Book Title: Journal of Clinical Medicine
Volume: 9
Issue: 9
Copyright Statement: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
cardiovascular function
cardiac output
Doppler
fetal growth restriction
pre-eclampsia
FETAL-GROWTH RESTRICTION
CARDIAC-OUTPUT
IMPEDANCE CARDIOGRAPHY
HEMODYNAMICS
PREECLAMPSIA
PREGNANCY
ACCURACY
HEART
Doppler
cardiac output
cardiovascular function
fetal growth restriction
pre-eclampsia
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
cardiovascular function
cardiac output
Doppler
fetal growth restriction
pre-eclampsia
FETAL-GROWTH RESTRICTION
CARDIAC-OUTPUT
IMPEDANCE CARDIOGRAPHY
HEMODYNAMICS
PREECLAMPSIA
PREGNANCY
ACCURACY
HEART
1103 Clinical Sciences
Publication Status: Published
Article Number: ARTN 2891
Online Publication Date: 2020-09-07
Appears in Collections:Department of Metabolism, Digestion and Reproduction



This item is licensed under a Creative Commons License Creative Commons