Baseline Diameters of Inferior Vena Cava and Abdominal Aorta Measured by Ultrasonography in Healthy Term Neonates During Early Neonatal Adaptation Period (original) (raw)
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Journal of South Asian Federation of Obstetrics and Gynaecology, 2022
Background: Umbilical vessels are an extension of the fetal cardiovascular system, which are essential parts of fetal circulation and fetal wellbeing. Umbilical vessels are altered in maternal and fetal conditions, so they can be used to predict adverse pregnancy outcomes. Prenatal sonographic studies have developed nomograms of umbilical vessels in normal pregnancies and established their relationship with fetal biometry. However, there is a scarcity of such studies in the postnatal period. Aim and objective: The aim and objective is to develop postdelivery histomorphometrical reference values for area and diameter of umbilical vessels across the available gestational age (GA) spectrum in low-risk pregnancies and secondly to examine the nature of its association with neonatal anthropometry. Materials and methods: A cross-sectional study was carried out on 164 low-risk pregnant women between GA of 32 and 42 weeks. Umbilical cord (UC) samples were procured soon after delivery. Formalin-fixed paraffin-embedded tissue blocks were processed, stained, and histomorphometric measurements of umbilical vessels were carried out by Olympus microscope. Neonatal anthropometry was noted. The mean and percentile were calculated for each GA. Pearson's Correlation was used to assess the relationship between umbilical vessels parameters with neonatal anthropometry. Results: Reference values and percentiles of diameter and area of umbilical vessels for each GA were calculated. Cross-sectional area and diameter of umbilical vein (UV) attained peak at 34 weeks of GA whereas both umbilical arteries (UAs) reached the peak at 36 weeks of GA and stabilized thereafter. A statistically significant positive correlation was observed between all umbilical vessels parameters with all neonatal anthropometric measurements (p <0.001). The regression equation for the prediction of newborn birth weight (y) according to the area (A) of umbilical vessels is 1.750 + 0.343(UA2A) + 0.248(UVA). It shows that the area of UA2 and UV are good predictors of newborn birth weight. Conclusion: The study provides reference values of umbilical vessels area and diameter of post-delivery from 32 to 42 weeks of gestation in low-risk pregnancies. These reference values of umbilical vessels provide baseline values for pathological and perinatal studies in the future. The study showed a positive relationship between umbilical vessels measurements and neonatal anthropometry. These results may be useful during perinatal pathological examination of UC and can be used as a predictor for neonatal complications.
Neonatal Arterial Morphology Is Related to Body Size in Abnormal Human Fetal Growth
Circulation. Cardiovascular imaging, 2016
Restriction in fetal growth is associated with cardiovascular disease in adulthood. It is unclear whether abnormal intrauterine growth influences arterial morphology during the fetal or neonatal stage. The objective was to study the regional arterial morphology with respect to gestational age and abnormal fetal body size. We studied body anthropometrics and arterial morphology and physiology in 174 neonates born between 31 and 42 weeks of gestation, including neonates with birth weights appropriate, small, and large for age, with very high resolution vascular ultrasound (35-55 MHz). In simple linear regressions, parameters of body size (body weight, body surface area, and organ circumference) and gestational age were statistically significantly associated with common carotid, brachial, femoral arterial parameters (lumen diameter [LD], wall layer thickness [intima-media thickness and intima-media-adventitia thickness], and carotid artery wall stress [CAWS]). Male sex was statisticall...
Arterial health during early childhood following abnormal fetal growth
BMC Pediatrics, 2022
Background Abnormal fetal growth is associated with increased cardiovascular risk in adulthood. We investigated the effect of fetal programming on arterial health and morphology during early childhood. Methods We examined 90 children (median age 5.81 years, interquartile range: 5.67; 5.95), born small for gestational age with fetal growth restriction, large or appropriate for gestational age (SGA, N = 23, LGA, N = 19, AGA N = 48). We measured body composition, anthropometrics, blood pressure, pulse wave velocity (PWV), lipids, glucose and inflammatory markers, and assessed carotid, brachial, radial and femoral arterial morphology and stiffness using very-high resolution ultrasound (46–71 MHz). Results LGA showed increased anthropometry, lean body mass and body mass index. SGA displayed decreased anthropometry and lean body mass. Blood pressure, PWV, carotid artery stiffness and blood work did not differ groupwise. Differences in lumen diameters, intima-media thicknesses (IMT) and ad...
Aortic wall thickness in newborns with intrauterine growth restriction
The Lancet, 2005
Much recent research has addressed the role that the fetal environment might have in adult health. In many but not all studies, low birthweight seems to be associated with an increase in cardiovascular risk similar to that seen with major environmental risk factors, such as cigarette smoking or hypertension. 1 The mechanisms whereby slowed intrauterine growth confers vascular risk are not clearly established, particularly whether fetal events might result in any arterial abnormalities in newborn babies.
Is there a relationship between high birth weight and umbilical vein diameter?
The Journal of Maternal-Fetal & Neonatal Medicine, 2020
Objective: The aim of the study was to evaluate the associations between sonographical measurements of the umbilical cord and birth weight in 20-24 weeks of gestations. Methods: This cross-sectional study was conducted with the participation of 220 low-risk pregnant women between 20-24 gestational weeks. Biparietal diameter, head and abdominal circumference, and femur length were measured for anthropometric calculations. Umbilical cord including umbilical vein diameters, placental thickness, umbilical artery. Doppler measurements (RI, PI) were recorded. Results: In accordance with the results of statistical computations, an inverse relationship was found between umbilical vein diameter and birth weight of a large gestational age (LGA) newborn in 20-24 gestational weeks (p < .05). There was no significant relationship between other parameters and birth weight of LGA newborns. Conclusion: There is an inverse relationship between birth weights of newborns with LGA and umbilical vein diamater at 20-24 weeks of pregnancy. The umbilical vein diameter in the second trimester may be a promising measurement on predicting LGA fetus. The researches have not confirmed the physiopathology of this finding yet, but it is paving the path for future studies.
Aorta Structural Alterations in Term Neonates: The Role of Birth and Maternal Characteristics
BioMed Research International, 2013
Aim. To evaluate the influence of selected maternal and neonatal characteristics on aorta walls in term, appropriately grownfor-gestational age newborns. Methods. Age, parity, previous abortions, weight, height, body mass index before and after delivery, smoking, and history of hypertension, of diabetes, of cardiovascular diseases, and of dyslipidemia were all assessed in seventy mothers. They delivered 34 males and 36 females healthy term newborns who underwent ultrasound evaluation of the anteroposterior infrarenal abdominal aorta diameter (APAO), biochemical profile (glucose, insulin, total cholesterol, HDL and LDL cholesterol, triglycerides, fibrinogen, and D-dimers homeostasis model assessment [HOMA IR ]index), and biometric parameters. Results. APAO was related to newborn length ( = +0.36; = 0.001), head circumference ( = +0.37; = 0.001), gestational age ( = +0.40, = 0.0005), HOMA index ( = +0.24; = 0.04), and D-dimers ( = +0.33, = 0.004). Smoke influenced APAO values (odds ratio: 1.80; confidence interval 95%: 1.05-3.30), as well as diabetes during pregnancy ( = +0.42, = 0.0002). Maternal height influenced neonatal APAO ( = +0.47, = 0.00003). Multiple regression analysis outlined neonatal D-dimers as still significantly related to neonatal APAO values. Conclusions. Many maternal and neonatal characteristics could influence aorta structures. Neonatal D-dimers are independently related to APAO.
Al-Azhar Medical Journal, 2021
Background: Intrauterine growth retardation (IUGR) is an obstetrical syndrome that is generally associated with increased mortality and morbidity. In IUGR, maternal placental blood flow is extremely compromised and that worsen the inter-villous circulation leading to an end-stage fetal distress. Objective: To compare TCD/AC ratio in both normal and growth restricted fetuses in second and third trimesters and to find if there is any correlation between TCD/AC ratio and EFW. Patients and methods: The study was conducted on 100 singleton pregnant women at EL-Sayed Galal University Hospital and Damanhour Teaching Hospital in the period between March 2019 till May 2020 and the patients were divided into two main equal groups. Group I included pregnant females with normally growing fetuses and Group II included pregnant females with growth restricted fetuses above 20 weeks of gestation. Results: This study demonstrated the usefulness of the single cutoff value (13.75%) of the TCD/AC ratio which may contribute to the early identification of SGA infants. The problem lied in identifying the process at the onset or before the IUGR has become severe. Usually the first parameter to decrease is the fetal AC due to depletion of hepatic glycogen and subcutaneous fat stores. The TCD/AC ratio, which utilized a single cutoff value (13.75%) independent of GA, improved diagnostic sensitivity and specificity in these cases. The possible contribution of the TCD/AC ratio in identifying the fetal growth failure itself, which was more important than predicting weight at birth to be further evaluated. There was no correlation between TCD/AC ratio and EFW and no statistical significant correlation between TCD/AC ratio and UA Doppler. Conclusion: In IUGR fetuses, the fetal TCD was less affected than fetal head circumference (HC) suggesting preferential preservation of cerebellar growth relative to other cranial structures. The TCD/AC ratio was helpful in recognizing abnormal fetal growth even when the GA was uncertain since this ratio was gestational age-independent.
Iranian Journal of Radiology, 2014
Background: It has been established that presence of lean umbilical cord with reduced Wharton's jelly in sonographic scans is a fetal marker for risk of small for gestational age at birth. With improvement of ultrasound techniques, more studies have been investigating the alterations of the umbilical cord on pregnancy outcomes. Objectives: To determine the reference ranges of the umbilical cord area during pregnancy and to find out the association between umbilical cord morphometry and fetal anthropometric measurements. Patients and Methods: A cross sectional study was carried out on a study population of 278 low-risk pregnant women between 15 and 41 weeks of gestational age. Fetal anthropometric measurements including biparietal diameter, abdominal circumference, and femur length were calculated. The measurements of the cross-sectional area (CSA) and circumference of the umbilical cord, vein and arteries were done on an adjacent plane to the insertion of umbilical cord into the fetus's abdomen. The mean and standard deviation of the CSA of the umbilical cord and the 5th, 10th, 50th, 90th, 95th percentiles of it were calculated for each gestational age. Pearson correlation coefficient was used to assess the correlation between the measures of the cord and fetal anthropometric measurements. Polynomial regression analysis was performed for curves.
Prenatal Diagnosis, 2011
Objective To develop reference ranges of fetal aortic and pulmonary valve diameter derived from volume datasets of spatio-temporal image correlation (STIC). Methods A cross-sectional study was undertaken on low-risk pregnancies with well-established data from 14 to 40 weeks. Volume datasets of STIC were acquired for subsequent off-line analysis. Aortic and pulmonary valve diameters were measured in STIC multiplanar view using 4D-View version 9. Normal Z scores and centile reference ranges were constructed from these measurements against gestational age (GA) and biparietal diameter (BPD) as independent variables, using regression models for both mean and SD. Results A total of 606 volume datasets were successfully measured. Normal reference ranges for predicting mean values and SD of aortic and pulmonary valve diameter were constructed based on best-fit equations (linear function) as follows: mean aortic diameter (mm) was modeled as a function of GA (weeks) and BPD (mm) as −2.4838 + 0.2702 × GA, (SD = 0.1482 + 0.0156 × GA) and −1.5952 + 0.0989 × BPD (SD = 0.1672 + 0.00572 × BPD). Mean pulmonary diameter was modeled as −2.5924 + 0.2935 × GA (SD = 0.2317 + 0.01524 × GA) and −1.6830 + 0.1083 × BPD (SD = 0.1971 + 0.0059 × BPD). Conclusion We have provided nomograms and Z scores of fetal aortic and pulmonary valve diameters. These reference ranges may be a useful tool in the assessment of fetal cardiac abnormalities.