Doppler echocardiography of the main stems of the pulmonary arteries in the normal human fetus (original) (raw)
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Aim: To assess pulmonary hemodynamic changes through colour Doppler Echocardiography along with clinical profile amongst pregnant women during the course of pregnancy. Materials and Methods: Pulmonary hemodynamic parameters were longitudinally assessed in 75 women (60 pregnant and 15 non-pregnant women) attending Department of Medicine and Department of obstetrics and Gynecology of LLRM Medical College, Meerut from I trimester to III trimester of Pregnancy and 6 weeks after delivery. Mean Pulmonary artery pressure was calculated from pulsed Doppler pulmonary velocities. Pulmonary flow was measured by Doppler and cross sectional echocardiography. These two measurements were used to calculate pulmonary vascular resistance. Results: Echocardiographically, Pulmonary artery pressures revealed a moderate rising trend with advancement of pregnancy, but it was not found to reach statistical significance. Longitudinal estimation of pulmonary vascular resistance revealed fall of 15% in first trimester and up to 17.5% in second trimester, with a trend of returning of baseline values by the end of 6 weeks of Puerperium. Conclusion: There was significant increase in mean pulmonary blood flow, significant decrease in pulmonary vascular resistance, no statistical increase in pulmonary artery pressure with advancement of pregnancy.
Iranian Journal of Pediatrics
Background: Doppler-derived fetal pulmonary artery acceleration time (PAAT) and acceleration-to-ejection time ratio (AT/ET) are important as predictors of a variety neonatal pulmonary diseases. The evaluation of PAAT and PA AT/ET are meaningful when simultaneous right and left heart studies are done. The unique cardiovascular physiology in the fetus, as the only period of life with physiologic systemic pulmonary hypertension, overemphasizes the significance of simultaneous study. However, studies on comparative fetal velocitometry of PA and aorta are scarce. Objectives: The aims of this study were to provide reference values for peak systolic velocity (PSV), pulsatility index (PI), acceleration time (AT), ejection time (ET) and AT/ET ratio of PA and aorta in the singleton pregnancies with healthy fetuses. We compared these Doppler parameters of PA and aorta. Methods: A cross-sectional study was performed on 146 fetuses. We measured PSV, PI, AT, ET and AT/ET in the PA and aorta and compared the values. We evaluated the correlation between these parameters and the fetal gestational age (GA). Results: Mean ± SD of gestational age of fetuses were 21 ± 4 weeks. PSV, AT and AT/ET of PA and aorta increased with gestational age.
Ultrasound in Medicine & Biology, 1993
To establish the relationship between flow velocity waveform patterns from the fetal pulmonary trunk and ductus arteriosus in normal late first-and second-trimester pregnancies, Doppler ultrasound examinations in these vessels were performed in 133 healthy women between 9 and 25 weeks of gestation. Differentiation between pulmonary and ductal blood flow was possible as from 12 weeks onwards resulting in a study population of 78 women. A linear gestational age-dependent increase in peak systolic velocity was found for both the pulmonary trunk and the ductus arteriosus. Ductal peak systolic velocity rose significantly faster with gestational age than pulmonary peak systolic velocity. This may be determined by differences in morphology and effective lumen between these two vessels.
2015
Keywords: Doppler Echo, pulmonary hemodynamic, pregnancy. Aim: To assess pulmonary hemodynamic changes through colour Doppler Echocardiography along with clinical profile amongst pregnant women during the course of pregnancy. Materials and Methods: Pulmonary hemodynamic parameters were longitudinally assessed in 75 women (60 pregnant and 15 non-pregnant women) attending from I trimester to III trimester of Pregnancy and 6 weeks after delivery. Mean Pulmonary artery pressure was calculated from pulsed Doppler pulmonary velocities. Pulmonary flow was measured by Doppler and cross sectional echocardiography. These two measurements were used to calculate pulmonary vascular resistance. Results: Echocardiographically, Pulmonary artery pressures revealed a moderate rising trend with advancement of pregnancy, but it was not found to reach statistical significance. Longitudinal estimation of pulmonary vascular resistance revealed fall of 15% in first trimester and up to 17.5% in second trime...
Fetal branch pulmonary arterial vascular impedance during the second half of pregnancy
American Journal of Obstetrics and Gynecology, 1996
OBJECTIVE: Our purpose was to establish normal physiologic parameters in the fetal proximal and distal branch pulmonary arterial vascular impedance during the second half of pregnancy and to analyze relationships between proximal and distal pulmonary arterial blood velocity waveforms. STUDY DESIGN; In this cross-sectional study 100 uncomplicated singleton pregnancies were studied by pulsed color Doppler techniques between 18 and 41 weeks of gestation (median 30 weeks). Both right and left proximal (immediately after the bifurcation of the main pulmonary artery) and distal (beyond the first bifurcation of the branch pulmonary artery) pulmonary artery blood velocity waveforms were recorded and pulsatility index values were calculated. Peak systolic velocities and time-to-peak-velocity intervals were measured. Time-to-peak-velocity intervals were also analyzed at the level of aortic and pulmonary valves and at the ductus arteriosus. Right and left pulmonary artery diameters and right lung length were measured. RESULTS: In both right and left proximal and distal pulmonary arteries pulsatility index values decreased (/9 < 0.0001) and the peak systolic velocities (p < 0.003) and time-to-peak-velocity intervals (/9 < 0.0001) increased during the second half of pregnancy. In the proximal pulmonary arteries the pulsatility index values decreased linearly until 34 to 35 weeks of gestation and in the distal pulmonary arteries until 31 weeks of gestation. Thereafter they remained unchanged. In pulmonary arteries time-to-peak-velocity intervals were shorter (p < 0.01) than at the pulmonary valve level. There were no significant differences between the right or left pulmonary arteries in the pulsatility index values, peak systolic velocities, time-to-peak-velocity intervals, or pulmonary artery diameters. In the proximal pulmonary arteries the pulsatility index values (p < 0.02) and peak systolic velocities (p < 0.0001) were higher and time-to-peak-velocity intervals 09 < 0.0001) were longer than in the distal pulmonary arteries. There was a 2.5-fold increase in pulmonary artery diameters and right lung length. CONCLUSIONS: Fetal branch pulmonary arterial vascular impedance decreases significantly during the second half of pregnancy. The linear decrease in vascular impedance during the second trimester and in the beginning of the third trimester may be related to the growth of the lung and the increase in the number of resistance vessels. During the latter part of the third trimester pulmonary vascular impedance does not decrease further.
Aims and Objectives: To assess pulmonary hemodynamic changes through colour Doppler Echocardiography along with clinical profile amongst pregnant women during the course of pregnancy. Material and Methods: Pulmonary hemodynamic parameters were longitudinally assessed in 75 women (60 pregnant and 15 non-pregnant women) attending Department of Medicine and Department of obstetrics and Gynecology of LLRM Medical College, Meerut from I trimester to III trimester of Pregnancy and 6 weeks after delivery. Mean Pulmonary artery pressure was calculated from pulsed Doppler pulmonary velocities. Pulmonary flow was measured by Doppler and cross sectional echocardiography. These two measurements were used to calculate pulmonary vascular resistance. Results: Echocardiographically, Pulmonary artery pressures revealed a moderate rising trend with advancement of pregnancy, but it was not found to reach statistical significance. Longitudinal estimation of pulmonary vascular resistance revealed fall of 15% in first trimester and up to 17.5% in second trimester, with a trend of returning of baseline values by the end of 6 weeks of Puerperium. Conclusion:-There was significant increase in mean pulmonary blood flow, significant decrease in pulmonary vascular resistance, no statistical increase in pulmonary artery pressure with advancement of pregnancy.
Doppler study of the peripheral flows in early gestation
Journal of physiology and pharmacology : an official journal of the Polish Physiological Society, 2008
The aim of this study was to determine the first trimester human peripheral arterial and venous blood flow between 5 - 10 weeks of gestation. Two hundred twenty four women with singleton, uncomplicated pregnancies were prospectively studied with transvaginal ultrasound. Ductus venosus, umbilical artery waveforms and pulsatility indexes (PI) were assessed as well as the waveform of the umbilical vein and the mean velocity (V(mean)) of the umbilical artery flow. The heart rate was also obtained and analyzed. The fetal heart rate showed a positive correlation with increasing gestational age R=0.76 (p<0.000001). Recordings from the umbilical artery, umbilical vein and ductus venosus were obtained starting from 7 weeks of gestation. The signal from the ductus venosus presented always as antegrade flow during atrial contractions. The pulsatility index (PI) of DV as well as PI of the umbilical artery remained unchanged during the study (statistically non-significant). The umbilical arte...
Pediatric Research, 2004
The aim of this study was to assess pulmonary arterial blood flow changes induced by the creation of a systemic arteriovenous fistula (120 d gestation) in the fetal lamb using Doppler technique. Doppler echocardiographic assessment of the pulmonary artery blood flow performed 1, 6, and 14 d after surgery showed that mean pulmonary arterial blood flow in the left or right pulmonary artery was 224 Ϯ 58 mL/min at day 1 in the fistula group, significantly higher than in the control group (113 Ϯ 22 mL/min; p Ͻ 0.01, ANOVA test) whether no difference was found at days 6 and 14. The mean inner diameter of the left pulmonary artery measured on postmortem lung arteriograms compared favorably to the one measured on day 14 at the same level on ultrasound. The mean left pulmonary arterial blood flow, measured at birth on day 14 after surgery, using ultrasonic flow transducer, was not statistically different from the one measured by Doppler on day 14. Our data demonstrate that echocardiography allows accurate assessment of pulmonary arterial blood flow in utero, providing evidence suggesting transient high pulmonary blood flow that did not last Ͼ6 d after the creation of a systemic fistula. (Pediatr Res 56: 385-390, 2004) Abbreviations DA, ductus arteriosus FHR, fetal heart rate LPA, left pulmonary artery PPHN, persistent pulmonary hypertension of newborn RPA, right pulmonary artery
Ultrasound in Obstetrics and Gynecology, 1999
Objective To establish the nature and gestational age dependency of the pulmonary venous flow velocity pattern into the left atrium relative to systolic and diastolic phases of the cardiac cycle. Design This was a cross-sectional study of Doppler measurements of fetal pulmonary venous inflow velocities, which were correlated with simultaneous recordings of transmitral and aortic flow velocity waveforms based on an equal cardiac cycle length (± 5%). Results Successful recordings were obtained in 28 out of 60 (47%) normal singleton pregnancies at 20-36 weeks of gestation. Reproducibility of waveform analysis of the various phases of the cardiac cycle was satisfactory, withinpatient variance ranging between 1.7% and 6.5%. A statistically significant increase (p < 0.05) in pulmonary venous time average velocity and velocity integral with advancing gestational age was established. A statistically significant increase (p < 0.05) of the pulmonary flow velocity integral was also found when related to each of the systolic and diastolic segments of the cardiac cycle, with the exception of isovolemic relaxation time. The duration of each of the diastolic and systolic segments of the cardiac cycle, as well as the pulmonary venous velocity integral expressed as a percentage of the cardiac cycle, remained constant with advancing gestational age. Conclusions The second half of pregnancy is characterized by pulmonary venous inflow into the left atrium throughout the cardiac cycle. Pulmonary venous inflow into the left atrium occurs predominantly during the filling and ejection phases of the cardiac cycle. Absolute cardiac diastolic and systolic time intervals as well as the percentage distribution of pulmonary venous flow velocity integrals between these cardiac time intervals remain unchanged with advancing gestational age.