Arterial blood flow velocity waveforms of the pelvis and lower extremities in normal and growth-retarded fetuses

Article Abstract:

Most studies examining fetal blood flow have used animal models, since the only means available for making such measurements were invasive (required entry into body). Pulsed Doppler ultrasonography is a noninvasive technique that can be used to measure fetal blood flow and can thus be used on humans. It involves using high-frequency sound waves (ultrasound) to produce images of vessels, from which flow measurements can be made. These measurements may be useful both in examining fetal development and in diagnosing the cause of abnormal fetal development. Doppler flow measurements were taken of the femoral artery in the lower extremities of 12 fetuses throughout development, and of the femoral, iliac and umbilical arteries of 30 other fetuses on one occasion. In addition, flow measurements were taken in the femoral and umbilical arteries of 20 fetuses suffering from intrauterine growth retardation (IUGR) at gestational age between 24 and 36 weeks. Results showed that in the 12 fetuses followed during development, femoral artery flow increased with fetal development. External iliac and femoral artery flow were similar in the normal fetuses, and umbilical flow was significantly lower than iliac flow. In the infants with IUGR, abnormally high femoral artery flow was detected in two fetuses who died, and abnormal or reverse umbilical flow was detected in 10 others, of whom four died. These results indicate that Doppler measurements of fetal femoral artery blood flow are not as good an indicator of fetal outcome as is Doppler measurement of umbilical artery blood flow. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Measurement, Fetus, Medical examination, Fetal growth retardation, Blood circulation, Prenatal diagnosis, Umbilical arteries

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Amniotic fluid glucose and intraamniotic infection

Article Abstract:

Prematurity is the major cause of illness and death in newborns, and uterine infections are a significant cause of premature deliveries. However, traditional tests for infection in which culturing of bacteria from samples is needed are often ineffective. The usefulness of Gram's stain (a type of dye used on microscopic slides) in identifying bacterial infection was compared with the efficacy of measuring levels of glucose in the amniotic fluid of 39 patients with premature labor. In the nine patients with infections, significantly lower amniotic fluid glucose levels were recorded, while maternal blood glucose levels did not differ between the two groups. Of 12 patients with amniotic fluid glucose levels less than 10 milligrams per 100 milliliters (mg/dl), 9 had infections and 3 delivered infants within 72 hours. All patients with glucose levels below 10 mg/dl had bacteria or white blood cells (an indicator of inflammation) visualized with Gram's stain. Two patients without infections had two apparently positive signs of infection, low glucose levels and white blood cells. These results suggest that low amniotic fluid glucose levels may be more indicative of uterine infection than Gram's stain tests for bacteria. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Complications and side effects, Pregnancy, Complications of, Pregnancy complications, Chorioamnionitis

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Doppler flow velocimetry of the splenic artery in the human fetus: is it a marker of chronic hypoxia?

Article Abstract:

Blood flow through the artery serving the spleen appears to be associated with small-for-gestational-age (SGA) fetuses. Fifteen SGA fetuses had a Doppler ultrasound scan. Fourteen of them showed enhanced blood flow through the splenic artery, of which one-third were markedly higher. This finding makes sense because growth retardation can result from inadequate oxygen supply, and one response to insufficient oxygen supply is to increase the number of red blood cells. The fetal spleen either makes new red blood cells or traps immature cells made elsewhere and matures them.

Usage, Diagnosis, Fetal anoxia

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