OP22.08: Intrapulmonary circulation in growth restricted fetuses with and without pre‐eclampsia
Year: 2012
Type: conference-abstract
Abstract: To evaluate blood flow velocity waveforms of fetal segmental pulmonary vessels in growth restricted fetuses of pregnancies with and without pre-eclampsia (PE) from 25–40 weeks of gestation. A total of 75 pregnancies with growth restricted fetuses were included; 19 were complicated by PE. Congenital anomalies and chromosomal abnormalities were excluded. Pulmonary blood flow waveforms were obtained at the level of the four-chamber view of the fetal heart in the main stem, middle, and distal branch of the intrapulmonary artery. The peak systolic (PS) velocity, pulsatility index (PI), and peak early diastolic reversed flow (PEDRF) were measured. Linear mixed models were used to test for differences in the log transformed mean pulmonary Doppler parameters in these pregnancies and as a function of gestational age (GA) at examination using a robust covariance matrix estimator. In the comparison between patients with PE and those without, the mean GA at ultrasound examination was 32.6 + 3.8 vs. 33.8 + 3.6 weeks (P = 0.21). Growth restricted fetuses of pregnancies affected with PE had a significantly higher mean log transformed PI of the distal pulmonary branch than growth restricted fetuses of pregnancies unaffected by PE adjusted for GA at examination (P = 0.002). While further adjustment for maternal age, body mass index and nulliparity did not alter the association, adjustment for betamethasone administration prior to examination slightly weakened the relationship between PI of the distal pulmonary branch and PE (P = 0.02). Among growth restricted fetuses, those whose mothers had PE exhibited higher vascular resistance of the distal pulmonary branch than fetuses of unaffected pregnancies. Further investigation of postnatal long-term respiratory outcomes may be warranted to improve the understanding of in utero pathogenesis of neonatal respiratory disorders.
DOI: 10.1002/uog.11603
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1541824410