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Updated: Apr 14, 2026

Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Gestational dietary protein is associated with sex specific decrease in blood flow, fetal heart growth and post-natal
Juan H Hernandez-Medrano1, Katrina J Copping2, Andrew Hoare3
1School of Veterinary and Medical Science, University of Nottingham, Sutton Bonington, United Kingdom.
Insights
Male fetuses show increased uterine artery blood flow early in pregnancy. Maternal protein restriction impacts fetal cardiovascular development differently based on sex, affecting hemodynamics and long-term blood pressure.
Area of Science:
- Reproductive physiology
- Fetal development
- Maternal-fetal medicine
Background:
- Adverse pregnancy outcomes are more common in male fetuses.
- Sex-specific differences in feto-placental perfusion are linked to placental insufficiency and fetal growth restriction.
Purpose of the Study:
- To investigate sex-specific differences in placental perfusion.
- To correlate these perfusion changes with fetal growth.
- To examine the impact of maternal diet on uterine hemodynamics and fetal development.
Main Methods:
- Utilized Doppler ultrasonography to assess median uterine artery (MUA) blood flow and fetal development monthly from 36 days post conception (dpc) to term.
- Analyzed excised fetuses and placentae at 98 dpc (n=48).
- Investigated effects of varying dietary crude protein (CP) levels (7-18%) from 60 days prior to conception up to 98 dpc in heifers.
Main Results:
- MUA blood flow to male fetuses increased in early pregnancy, correlating with enhanced fetal growth.
- Protein restriction prior to 23 dpc increased MUA diameter and velocity indices in late pregnancy.
- Maternal diet influenced fetal cardiovascular development with sex-specific effects, including altered heart weight, heart rate, and later blood pressure.
Conclusions:
- Observed sex-specific differences in feto-placental Doppler perfusion indices and their response to dietary changes.
- Maternal diet significantly impacts fetal cardiovascular system development and in utero hemodynamics in a sex-biased manner.
- This study provides insights into gender-specific circulatory differences during the fetal period and cardiovascular system development.
Study Overview:
The incidence of adverse pregnancy outcomes is higher in pregnancies where the fetus is male. Sex specific differences in feto-placental perfusion indices identified by Doppler assessment have recently been associated with placental insufficiency and fetal growth restriction. This study aims to investigate sex specific differences in placental perfusion and to correlate these changes with fetal growth. It represents the largest comprehensive study under field conditions of uterine hemodynamics in a monotocous species, with a similar long gestation period to the human. Primiparous 14 mo heifers in Australia (n=360) and UK (n=180) were either individually or group fed, respectively, diets with differing protein content (18, 14, 10 or 7% crude protein (CP)) from 60 d prior to 98 days post conception (dpc). Fetuses and placentae were excised at 98 dpc (n = 48). Fetal development an median uterine artery blood flow were assessed monthly from 36 dpc until term using B-mode and Doppler ultrasonography. MUA blood flow to the male feto-placental unit increased in early pregnancy associated with increased fetal growth. Protein restriction before and shortly after conception (-60 d up to 23 dpc) increased MUA diameter and indices of velocity during late pregnancy, reduced fetal heart weight in the female fetus and increased heart rate at birth, but decreased systolic blood pressure at six months of age.
Conclusion And Significance:
Sex specific differences both in feto-placental Doppler perfusion indices and response of these indices to dietary perturbations were observed. Further, maternal diet affected development of fetal cardiovascular system associated with altered fetal haemodynamics in utero, with such effects having a sex bias. The results from this study provide further insight into the gender specific circulatory differences present in the fetal period and developing cardiovascular system.
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