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WS12‐04Fetal hemodynamics and growth restriction
Author(s) -
Clerici G.,
Di Renzo G. C.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00009-1-71.x
Subject(s) - medicine , hypoxemia , ductus venosus , hemodynamics , cardiology , fetus , hydrops fetalis , intrauterine growth restriction , decompensation , intracardiac injection , pregnancy , biology , genetics
Intrauterine growth restriction (IUGR) is a common symptom of many possible maternal‐fetal pathologies and/or the expression of a genetic alteration; by far, the most common etiology is related to chronic fetal hypoxemia. Fetal hypoxemia may be the result of different feto‐maternal pathophysiological processes which can produce completely different fetal hemodynamic modifications, not only in relation to the quality but particularly in relation to the chronology of the hemodynamic events. However, fetal hypoxia is mostly due to placental vascular insufficiency and it is important to point‐out that fetal hypoxemia‐acidemia is part of the terminal pathway starting from placental functional and structural alterations, through fetal IUGR, leading to intrauterine fetal death. Doppler evaluation of fetal arterial districts is important for the diagnosis of the fetal hemodynamic adaptation to the hypoxemia. Our observations suggest that, in the evaluation of fetal hemodynamics, it is important to consider also the intracardiac and the venous hemodynamics, focusing the study on the evaluation of the output tracts, the atrio‐ventricular flow and on vessels like the ductus venosus, inferior vena cava, umbilical vein. Keeping the time of the hemodynamic alterations in these vessels and/or districts, which are characteristic signs of the incipient heart failure, may be one of the key for the solution for one of the main obstetrical problem: the diagnosis of fetal decompensation phase.