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At least 991 records · Page 55Linked to original sources
PubMed2005

Ductus venosus shunting in marmoset and baboon fetuses.

OBJECTIVES: The increased shunting of blood through the ductus venosus (DV) during stress situations is an important mechanism that ensures fetal survival. Although primate fetuses may serve to study the function of this important venous shunt, the rate of DV shunting has not been determined in non-human primates under normal conditions. METHODS: DV shunting was measured in 11 marmoset (eight mothers) and eight singleton baboon fetuses in mid and late gestation using Doppler ultrasound. RESULTS: DV shunting in marmosets was 39 +/- 20% (mean +/- SD) and 28 +/- 8% in baboon fetuses. Umbilical vein (UV) blood volume rate increased significantly in baboons with gestational age (GA) (UV flow volume = -111.8 + 1.6*GA; r = 0.94, P < 0.05) and slightly in marmosets (UV flow volume = -10.37 + 0.13*GA; r = 0.42, P > 0.05). Both UV diameter (r = 0.84) and the time-averaged mean UV flow velocity in baboons depended on GA (r = 0.8, P < 0.05). Distinct pulsation was found in marmoset fetuses in the UV (pulsatility index (PI) = 1.3 +/- 0.9) and the DV (PI = 1.9 +/- 1.2) with zero blood flow velocity during atrial contraction. CONCLUSIONS: A high level of pulsation is observed in the UV in marmoset fetuses. DV shunting in marmosets is higher than in baboon fetuses.

Animals↗
PubMed2006

Metopic suture in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks of gestation.

OBJECTIVE: To investigate the development of the frontal bones and metopic suture in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks of gestation. METHODS: Three-dimensional (3D) ultrasound was used to measure the height of and gap between the frontal bones in 75 fetuses with trisomy 21 and these were compared to the measurements in 200 normal fetuses at 11 + 0 to 13 + 6 (median, 12 + 6) weeks of gestation. RESULTS: In the fetuses with trisomy 21, compared to the normal fetuses, there was no significant difference in either the height of the frontal bones (mean difference 0.16 SD, range -1.78 to 2.17 SD; P = 0.369) or the gap between them (mean difference 0.012, 95% CI -0.073 to 0.097; P = 0.780). Additionally, within the group of trisomy 21 fetuses there were no significant differences in the development of the frontal bones and metopic suture between those with absent (n = 46) and those with present (n = 29) nasal bone. CONCLUSIONS: In trisomy 21 the development of the frontal bones and metopic suture is as normal and is independent from the development of the nasal bones.

Adult↗
PubMed2006

Intracardiac Doppler assessment of left valve inflow in first-trimester fetuses with increased nuchal translucency: preliminary observations in trisomy 21.

OBJECTIVES: To perform a qualitative assessment of the pulsed Doppler waveform profile at the level of left atrioventricular valve inflow in first-trimester fetuses with increased nuchal translucency thickness (NT), in order to compare those with trisomy 21 and those with normal karyotype. METHODS: This was a review of 285 consecutive fetuses with increased NT. Pulsed Doppler velocity waveforms of left atrioventricular valve inflow were recorded. The E-wave, A-wave and velocity profile in the aorta were displayed. Cases were classified into two patterns: Pattern A included those in which the E-wave velocity crossed the A-wave before the baseline in all waveforms; Pattern B included those in which the lowest E-wave velocity crossed the baseline but not the A-wave in at least one of the profiles. The karyotype was determined and the frequency of occurrence of Patterns A or B in fetuses with normal karyotype and those with trisomy 21 were compared. RESULTS: Of the 285 cases, 230 were assigned to Pattern A and 55 to Pattern B. There were 47 cases of trisomy 21, 22 had other chromosomal abnormalities, and 212 had a normal karyotype; in four cases the karyotype was unknown. Among the 212 karyotypically normal fetuses, five had heart defects, five had other structural defects, three suffered spontaneous intrauterine death and one was terminated. Pattern A was found in 200/212 (94.3%) cases with normal karyotype, in 12/47 (25.5%) cases with trisomy 21, and in 17/22 (77.3%) cases with other chromosomal abnormalities. Pattern B was found in 12/212 (5.7%) cases with normal karyotype, in 35/47 (74.5%) cases with trisomy 21 (chi-square test, P < 0.001), and in 5/22 (22.7%) cases with other chromosomal abnormalities. CONCLUSIONS: Intracardiac Doppler qualitative assessment of left valve inflow in first-trimester fetuses with increased NT shows differences between normal and trisomy 21 fetuses, probably reflecting differences in myocardial function.

Adult↗
PubMed2006

Second-trimester intra-abdominal bowel dilation in fetuses with gastroschisis predicts neonatal bowel atresia.

OBJECTIVE: To determine in fetuses with gastroschisis the association between intra-abdominal bowel dilation in the second trimester and neonatal bowel atresia. METHODS: We reviewed ultrasound and medical records of fetuses with gastroschisis from January 1998 to August 2004. Fetuses with intra-abdominal bowel dilation in the second trimester were identified and followed into the neonatal period. RESULTS: We identified 58 mother-infant pairs showing fetal gastroschisis, with at least one prenatal ultrasound at our hospital and which were delivered there, or were transported there as newborns. Forty-eight of the 58 fetuses had no intra-abdominal bowel dilation and none of these neonates had bowel atresia. Ten of the 58 fetuses had intra-abdominal bowel dilation and all had bowel atresia at birth (P<0.0001). In eight cases in which ultrasound was performed at <25 weeks' gestation, intra-abdominal bowel dilation was already present. CONCLUSION: Intra-abdominal bowel dilation in the second trimester predicts neonatal bowel atresia in fetuses with gastroschisis.

Dilatation, Pathologic↗
PubMed2006

Fetal growth patterns in fetuses of women with pregestational diabetes mellitus.

OBJECTIVE: To assess the effect of glucose control on the rate of growth of fetuses in women with pregestational diabetes mellitus (Types 1 and 2). METHODS: All pregestational diabetic women booked at Mater Mothers' Hospital, Brisbane, Australia, between 1 January 1994 and 31 December 2002, were included. Pregnancies with congenital fetal anomalies, multiple pregnancies, and pregnancies terminated prior to 20 weeks' gestation were excluded. Dating scans were performed before 14 weeks' gestation and serial scans were performed at 18, 24, 28, 32 and 36 weeks. Fetal parameters, including biparietal diameter, femur length and abdominal circumference, were recorded. The daily growth rates for biparietal diameter, femur length, and fetal abdominal area were calculated and compared with those in a low-risk (non-diabetic) population. The growth rates in fetuses of women with satisfactory diabetic control (HbA1c < 6.5%) and unsatisfactory control (HbA1c > or = 6.5%) in the three trimesters were compared. RESULTS: A total of 174 diabetic pregnancies were included and a total of 997 ultrasound scans were performed. The growth rates for fetuses of mothers with diabetes mellitus were significantly higher than for those in the low-risk population. The z-scores for biparietal diameter, femur length, and fetal abdominal area were 0.18, 0.59 and 1.44, respectively. Fetuses of diabetic mothers with high HbA1c in the first trimester had significantly greater fetal abdominal area growth rate than those with normal HbA1c (fetal abdominal area z-score of 1.7 vs. 0.75, P = 0.009). Although the fetal abdominal area z-scores in fetuses of diabetic mothers with high HbA1c in the second or third trimesters were also higher than those with normal HbA1c levels, the differences did not reach statistical significance. Maternal obesity did not influence the fetal growth rate. CONCLUSION: The rate of growth of fetuses of diabetic mothers differs from that of the normal population. Growth acceleration persists until the late third trimester. Moreover, periconceptional glucose control appears to have a significant effect on accelerated growth of the fetal abdominal area.

Adult↗
PubMed2006

Brachycephaly and frontal lobe hypoplasia in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks.

OBJECTIVE: To investigate the incidence of brachycephaly and frontal lobe hypoplasia in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks of gestation. METHODS: A three-dimensional (3D) volume of the fetal head was obtained before fetal karyotyping at 11 + 0 to 13 + 6 (median, 12 + 5) weeks of gestation in 100 fetuses that were subsequently found to have trisomy 21 and in 300 fetuses subsequently found to be chromosomally normal. The multiplanar mode was used to obtain a sequence of transverse views of the fetal head and to demonstrate the biparietal and suboccipitobregmatic views. We measured the biparietal diameter (BPD), the occipitofrontal diameter (OFD) and the frontothalamic distance (FTD) between the inner table of the frontal bone and the posterior thalami. RESULTS: In the chromosomally normal group the BPD, OFD and FTD increased linearly with crown-rump length (CRL) from 16.7 mm, 19.0 mm and 12.1 mm at a CRL of 45 mm to 26.7 mm, 31.7 mm and 18.7 mm, respectively, at a CRL of 84 mm. In the trisomy 21 fetuses, compared to normal fetuses, there was shorter BPD (mean difference = -0.63 mm; 95% CI, -0.97 to -0.30 mm, P < 0.0001), OFD (mean difference = -1.41 mm; 95% CI, -1.75 to -1.07 mm, P < 0.0001) and FTD (mean difference = -0.77 mm; 95% CI, -1.02 to -0.54 mm; P < 0.0001) and higher BPD to OFD ratio (mean difference = 0.022; 95% CI, 0.012 to 0.032, P < 0.0001) but no significant difference in the FTD to OFD ratio (mean difference = 0.004; 95% CI, -0.006 to 0.013, P = 0.448). CONCLUSIONS: In fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks of gestation there is evidence of brachycephaIy but not of frontal lobe hypoplasia.

Adolescent↗
PubMed2004

Doppler application in the delivery timing of the preterm growth-restricted fetus: another step in the right direction.

This article provides an opinion on a study of relationships between umbilical artery (UA) Doppler, ductus venosus (DV) Doppler, fetal heart rate variation, and perinatal outcome in preterm, intrauterine growth-restricted (IUGR) fetuses published in the same issue of this journal by Bilardo and coworkers. Recent evidence on venous Doppler surveillance in preterm IUGR fetuses was also reviewed and discussed in the context of the study with a special emphasis on delivery timing. A search was conducted through MEDLINE and eight articles with similar inclusion criteria and reporting format of outcomes were identified. Numbers for perinatal mortality, intraventricular hemorrhage, respiratory distress syndrome, bronchopulmonary dysplasia and necrotizing enterocolitis (NEC) were extracted for cases where Doppler status was recorded in an identical format. Proportional distribution of outcomes was compared for fetuses with normal DV Doppler velocimetry, absent or reversed UA end-diastolic velocity (UA A/REDV), elevated DV Doppler index (abnormal DV) and absence or reversal of atrial velocity in the DV (DV-RAV). A total of 320 fetuses with normal and 202 with elevated DV Doppler indices were extracted. Of these fetuses, 101 with UA A/REDV only and 34 with DV-RAV were identified. Perinatal mortality was 5.6% (16/282) with normal DV, 11.9% (12/101) with UA A/REDV, 38.8% (64/165) with abnormal DV and 41.2% (7/17) with DV-RAV. With the exception of NEC, all complications were significantly more frequent with abnormal DV. With normal venous Doppler neonatal deaths account for most of the perinatal mortality, while with abnormal DV stillbirths and neonatal mortality are similar contributors to the significantly increased perinatal mortality. In conclusion, UA Doppler is a placental function test that provides important diagnostic and prognostic information in preterm IUGR. DV Doppler effectively identifies those preterm IUGR fetuses that are at high risk for adverse outcome (particularly stillbirth) at least 1 week before delivery, independent of the UA waveform. Relationships between perinatal outcome, arterial and venous Doppler status and gestational age require ongoing observational research effort. Randomized management trials are necessary to verify that delivery timing based on venous Doppler will impact on outcome in preterm IUGR.

Biomedical Research↗
PubMed2004

Likelihood ratio for trisomy 21 in fetuses with absent nasal bone at the 11-14-week scan.

OBJECTIVE: To update the likelihood ratio for trisomy 21 in fetuses with absent nasal bone at the 11-14-week scan. METHODS: Ultrasound examination of the fetal profile was carried out and the presence or absence of the nasal bone was noted immediately before karyotyping in 5918 fetuses at 11 to 13+6 weeks. Logistic regression analysis was used to examine the effect of maternal ethnic origin and fetal crown-rump length (CRL) and nuchal translucency (NT) on the incidence of absent nasal bone in the chromosomally normal and trisomy 21 fetuses. RESULTS: The fetal profile was successfully examined in 5851 (98.9%) cases. In 5223/5851 cases the fetal karyotype was normal and in 628 cases it was abnormal. In the chromosomally normal group the incidence of absent nasal bone was related first to the ethnic origin of the mother, being 2.2% for Caucasians, 9.0% for Afro-Caribbeans and 5.0% for Asians; second to fetal CRL, being 4.7% for CRL of 45-54 mm, 3.4% for CRL of 55-64 mm, 1.4% for CRL of 65-74 mm and 1% for CRL of 75-84 mm; and third to NT, being 1.6% for NT < or = 95th centile, 2.7% for NT > 95th centile-3.4 mm, 5.4% for NT 3.5-4.4 mm, 6% for NT 4.5-5.4 mm and 15% for NT > or = 5.5 mm. In the chromosomally abnormal group there was absent nasal bone in 229/333 (68.8%) cases with trisomy 21 and in 95/295 (32.2%) cases with other chromosomal defects. Logistic regression analysis demonstrated that in the chromosomally normal fetuses significant independent prediction of the likelihood of absent nasal bone was provided by CRL, NT and Afro-Caribbean ethnic group, and in the trisomy 21 fetuses by CRL and NT. The likelihood ratio for trisomy 21 for absent nasal bone was derived by dividing the likelihood in trisomy 21 by that in normal fetuses. CONCLUSION: At the 11-14-week scan the incidence of absent nasal bone is related to the presence or absence of chromosomal defects, CRL, NT and ethnic origin.

Adolescent↗
PubMed1995

Theoretical kidney volume versus real kidney volume: comparative evaluation in fetuses.

In order to present equations and normal growth curves of the theoretical kidney volume we studied 290 kidneys taken from 145 fresh human fetuses ranging in age from 13 to 36 weeks post-conception (WPC). The kidneys were evaluated in terms of greatest longitudinal length (L) superior pole width (SW), inferior pole width (IW), thickness (T) and real volume (RV). The theoretical kidney volume was calculated (ellipsoid formula: volume = length x width x thickness x 0.5236) by using SW, IW and the arithmetic mean between SW and IW. The assessment of the theoretical volume by using IW was well correlated with the real kidney volume. We found no statistically significant difference between right and left kidneys. During the second trimester (13 to 24 WPC) there was no difference in kidney volume between male and female fetuses. In the third trimester (25 to 36 WPC) male fetuses presented kidney volumes significantly greater than female fetuses. To evaluate the theoretical kidney volume in fetuses, one may use the IW, which is a quickly and easily obtained measurement. During the second trimester one may monitor the fetal kidney using equations and growth curves without taking the fetal sex into account. During the third trimester the fetal kidney volume must be evaluated using specific curves for male and female fetuses.

Embryonic and Fetal Development↗
PubMed1991

Scalp heat flux in postmature and in growth-retarded fetuses.

Postterm and growth-retarded fetuses share a common problem which can be characterized by a discrepancy between the supply of oxygen and nutrients to, and the demand of the fetus. But, this "insufficient" placental exchange function may also extend to and affect its thermal homeostasis; e.g. when the capacity of convective (placenta) pathways is shifted towards conductive (surface) pathways for heat loss. Therefore, fetal scalp heat flux measurements, where heat serves as an intrinsic tracer for metabolic activity and placental exchange function, promised a new kind of information. In 81 pregnant women during labor we measured fetal scalp heat flux by means of an heat flux transducer attached to the fetal head and after the cervix had dilated to 3 cm. In the healthy fetuses we found a positive linear relationship between scalp heat flux and different anthropometric variables such as body length (r = 0.432, n = 65, P less than 0.01), head circumference and gestational age. In comparison, postmature and growth-retarded fetuses showed higher heat flux values than appropriately grown fetuses of the same length head size and gestational age. Moreover, in those fetuses scalp heat flux decreased by approximately 4 watt/m2 during the second stage and differed in this regard from the control group who showed stable values during labor and delivery. We conclude that scalp heat flux measurements may indicate disturbances of placental exchange before acute hypoxia occurs.

Adult↗
PubMed1993

Haemodynamic changes in IUGR fetus with chronic hypoxia evaluated by fetal heart-rate monitoring and Doppler measurement of blood flow velocity.

The measurement of fetal blood flow velocity and 24 h monitoring of fetal heart-rate (FHR) using a computer were performed to clarify the haemodynamics of growth-retarded fetuses with chronic hypoxia. One hundred normal-growth and 18 growth-retarded fetuses were analysed. All the growth-retarded fetuses with chronic hypoxia were characterised by abnormal blood flow velocity waveforms (with the pulsatility index in the descending aorta below the -1.0 SD and in the middle cerebral artery above the +1.0 SD for our reference range, from 100 normal-growth fetuses). In the latter, the incidence of accelerations of defined size and variability in FHR patterns showed a diurnal variation after 30 weeks' gestation. The initial change in FHR patterns during hypoxia in 11 growth-retarded fetuses, resulting in fetal distress, was a derangement of diurnal variations in FHR patterns, followed by a decrease in variability. A rapid increase in blood flow velocity in the middle cerebral artery with the advance of hypoxia was observed before the onset of distress. Maternal low-dose oxygen inhalation elicited a temporary increase in FHR variability in the growth-retarded but not in normal fetuses. Re-inhalation after 1 h elicited a similar change, suggesting that intermittent rather than continuous, oxygen inhalation may be more effective.

Blood Flow Velocity↗
PubMedDate not supplied

Right ventricular dilatation in the fetus: a study of associated features and outcome.

Right ventricular dilatation is an infrequent finding at fetal echocardiography. Previous studies have documented an association with aortic coarctation. However, there are associations with other congenital abnormalities. We reviewed our experience of fetal right heart dilatation in order to recognize concurrent anomalies and to assess the outcome of the affected fetuses. We studied all fetuses with right ventricular dilatation over a 5-year period. We documented associated cardiac and noncardiac lesions, and outcome data were assessed in terms of the number of fetuses that were born live and the number surviving to 2 months of age. Forty-three fetuses with right heart dilatation were seen. Fifteen had associated cardiac abnormalities: most commonly coarctation (n = 4) and VSD (n = 4). Seven had associated noncardiac abnormalities. There were seven fetuses who also had chromosomal abnormalities. In total, there were three terminations of pregnancy, four intrauterine deaths, one stillbirth and 35 live-births. Twenty-eight were alive at 2 months of age (70% of the nonterminated pregnancies). Fetal right heart dilatation is frequently associated with both cardiac and noncardiac congenital abnormalities. Our outcome figures suggest a guarded prognosis be given during counseling of parents of fetuses with right heart dilatation.

Adult↗
PubMedDate not supplied

Congenital complete heart block in the fetus: hemodynamic features, antenatal treatment, and outcome in six cases.

Congenital heart block (CHB) can result in intrauterine cardiac failure leading to fetal or neonatal loss. To establish perinatal hemodynamic factors which might predict adverse outcome, six fetuses with CHB diagnosed between 20 and 30 gestational weeks were examined by echocardiography at 2-week intervals. Neonatal morbidity and outcome in infancy are detailed. The fetuses showed a significant decrease in ventricular rate (VR) with advancing gestation (60 +/- 7 vs 51 +/- 4 beats/min, p = 0.03). Cardiac decompensation defined as hydrops or pericardial effusion was associated with VR of lower than 55 beats/min in two fetuses. Three mothers had a therapeutic trial with a sympathomimetic and digoxin. Salbutamol increased VR 10% in one of three fetuses treated. Digoxin decreased pericardial effusion in one hydropic fetus with autoimmune myocarditis. In this fetus, poor left ventricular fractional shortening (LVFS) was accompanied with high umbilical artery resistance index (RI). High amniotic fluid erythropoietin indicated severe hypoxia preceding death. Pacemaker was indicated in all the newborns. At the age of 2 weeks all the surviving infants had tricuspid regurgitation and a shunt through foramen ovale due to asynchronized atrioventricular contraction. During the 12-month follow-up two of five surviving infants had no symptoms. One had symptomatic neonatal lupus. Two infants had patent ductus arteriosus, one with dilated cardiomyopathy. In conclusion, poor fetal outcome was associated with low VR, low LVFS, and high RI. Despite early pacing, morbidity was high in infancy due to cardiomyopathy and associated heart defects. Regular echocardiographic monitoring during pregnancy and after delivery is required in order to optimize care and timing of any interventions.

Adult↗
PubMedDate not supplied

Hemodynamic abnormalities in fetuses with congenital heart disease.

The purpose of this investigation was to assess left and right ventricular function, volume ejection fraction, combined stroke volume, and combined ventricular output in the human fetus with congenital heart disease compared to the normal healthy fetus. Seventy-two fetuses with a variety of in utero diagnosed congenital cardiac defects were compared with a control group of fetuses with structurally normal hearts matched for race, maternal age, and gestational age. We demonstrated significant hemodynamic changes in the fetus with congenital heart disease. There was a significant (p < 0.0001) decrease in the volume ejection fractions, biventricular stroke volume, and cardiac output in the congenital heart disease group compared to matched controls. Our findings suggest that hemodynamic abnormalities in the fetus with congenital heart disease are present before birth and we speculate that myocardial reserve may not be adequate to respond to hemodynamic stressors such as birth or heart surgery.

Adult↗
PubMedDate not supplied

Hepatic subcapsular hematomas in fetuses and neonatal infants.

In fetuses and neonates hepatic subcapsular hematomas are relatively common lesions and may be life-threatening. Conditions previously associated with these hematomas include trauma, coagulopathies, hypoxia, sepsis, pneumothorax, maternal diseases, and placental lesions. In this study of 755 perinatal autopsies, hepatic subcapsular hematomas were found in 52 (6.9%) cases, including 31 stillborn fetuses and 21 liveborn infants. The average body weight was 690 g. A comparison group consisted of 52 temporally proximal autopsies of fetuses and neonates without hematomas. Body weights, gender, maternal age, and stillbirth or postnatal survival were matched as closely as possible while evaluating the presence or absence of sepsis, pneumothorax, cerebral germinal matrix hemorrhage, trauma, coagulopathy, placental lesions, and maternal diseases. Sepsis was associated with 62% of the cases with hepatic subcapsular hematomas and with 25% of the comparison group (P =.0001). Group B streptococcus infection was the most common cause of sepsis, but many different organisms were isolated. Cerebral germinal matrix hemorrhages were present in 35% of the cases with hematomas and in 14% of the comparison group (P =.0001). No other lesions or conditions were statistically different in the study group versus the comparison group. The delicacy of the hepatic capsule and its connections to the collagen along the sinusoids provide insight for the pathogenesis of hematomas in premature fetuses and neonates. We conclude that sepsis is present in most perinatal cases of hepatic subcapsular hematomas and that such patients also frequently have cerebral germinal matrix hemorrhages. Each of these lesions is a greater hazard among very small premature fetuses or neonates than among older fetuses and neonates.

Adult↗
PubMed1986

Sequential nonstress testing with use of each fetus as its own control.

The sequential nonstress tests of 126 high-risk fetuses were assessed for baseline fetal heart rate, acceleration frequency, amplitude, and duration and the observance of fetal heart rate decelerations. In 108 fetuses (563 tests) with normal perinatal outcomes, no significant trends in these parameters were found. In 18 fetuses (104 tests) with perinatal compromise, 16 had significantly declining acceleration frequencies, 15 had decreasing acceleration duration, four had rising mean baseline rates, and seven, in their last test before delivery, had repetitive late or severe variable decelerations. The last tests of 11 of these 18 fetuses met institutional criteria for reactivity. When the nonstress tests of compromised fetuses were viewed sequentially, acceleration frequency declined by an average of 59% and acceleration duration by an average of 40%. Sequential assessment of the nonstress test, when compared with the use of standard reactivity criteria, improved test sensitivity from 39% to 89% and negative predictive value from 91% to 98%. We conclude that sequential nonstress test assessment in individual fetuses may improve the diagnostic value of this modality and lead to earlier recognition of fetal compromise.

Female↗
PubMed1988

Fetal heart rate and activity patterns in growth-retarded fetuses: changes after vibratory acoustic stimulation.

Seventeen pregnant women who subsequently were delivered of infants with birth weights less than the third percentile were studied for examination of fetal heart rate and fetal activity patterns before and after a 5-second external vibratory acoustic stimulation. None of the fetuses was acidotic at birth. A reduced time was noted during which accelerations in heart rate occurred (50% less) and long-term fetal heart rate variability (25% less) in small for gestational age fetuses compared with age-matched, normally grown fetuses. The incidence of gross fetal body movements was significantly lower (40% less) in small for gestational age fetuses than in those who were appropriate for gestational age. Fetal heart rate and fetal activity patterns after stimulation with the electronic artificial larynx in small for gestational age fetuses were similar to those of appropriate for gestational age fetuses.

Acoustic Stimulation↗
PubMed1988

Responsiveness to norepinephrine of the vessels supplying the placenta of growth-retarded fetuses.

The effects of intravenous norepinephrine infusions on uteroplacental blood flow were studied in seven awake, chronically catheterized guinea pigs at 63 to 64 days' gestation after unilateral uterine artery ligation at days 31 to 37. An initial subpressor dose of norepinephrine (1.54 +/- 0.18 nmol/kg.min) (+/- SEM) was given, followed by a pressor dose (4.57 +/- 0.59 nmol/kg.min) that caused a 14% increase in mean arterial blood pressure. Placental blood flow as measured by the microsphere technique decreased by 24% in 11 placentas with normal-sized fetuses during the subpressor dose and by 46% during the pressor dose. In 11 placentas with growth-retarded fetuses the two norepinephrine doses reduced blood flow by 19% and 43%, respectively. These results indicate that there is no difference in adrenergic responsiveness between the vessels supplying the placenta of a normal-sized fetus and the arteries of the placenta of a growth-retarded guinea pig. It is suggested that an increase in circulating maternal catecholamine levels would affect a growth-retarded fetus more severely than the normal-sized fetus because the growth-retarded fetus even during normal conditions exists at, or even beyond, the border of imminent asphyxia and hypoglycemia.

Animals↗