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Am J Physiol Heart Circ Physiol (November 20, 2003). doi:10.1152/ajpheart.00523.2003
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Submitted on June 6, 2003
Accepted on November 17, 2003

Relationships between Doppler-derived umbilical artery absolute velocities, cardiac function, and placental volume blood flow and resistance in fetal sheep

Ganesh Acharya1*, Tiina Erkinaro2, Kaarin Makikallio3, Tomi Lappalainen2, and Juha Rasanen3

1 Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromso, Norway
2 Department of Anesthesiology, University of Oulu, Oulu, Finland
3 Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland

* To whom correspondence should be addressed. E-mail: ganesh.acharya{at}unn.no.

We hypothesized that umbilical artery absolute blood flow velocities measured by Doppler ultrasonography reflect placental volume blood flow (QUA) and placental vascular resistance (RUA) in a late gestation fetal sheep model. In addition, we examined the relationships between umbilical artery absolute blood flow velocities and parameters of fetal cardiac function. Twenty six sheep fetuses were instrumented at 112-132 days of gestation. After a five-day recovery period, experiments were performed under general anesthesia in 16 normal fetuses, in 5 fetuses after maternal administration of phenylephrine, and in 5 fetuses after placental embolization. The QUA. and arterial blood pressures were measured using a transit-time ultrasonic flow probe and a catheter placed into the descending aorta, respectively. Umbilical artery (UA) peak systolic velocity (PSV), end diastolic velocity (EDV), time- averaged maximum velocity (TAMXV), pulsatility index (PI), and mean velocity (Vmean), and fetal cardiac output, ventricular ejection forces, and the proportion of isovolumetric relaxation time (IRT%) in the cardiac cycle were measured by Doppler ultrasonography. Significant positive linear correlations were found between UA EDV, TAMXV and Vmean vs. QUA, while UA PI had a significant negative correlation with QUA. Significant negative correlations were shown between UA EDV, TAMXV and Vmean vs. RUA. A significant positive correlation was present between UA PI and RUA. Dopplerderived umbilical artery parameters did not correlate with fetal arterial blood pressures, cardiac output, ventricular ejection forces or IRT%. In fetal sheep, Doppler-derived UA PI and absolute velocities, except PSV, are closely related to directly measured QUA and RUA validating the use of noninvasive Doppler velocimetry in the assessment of placental circulation.




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