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Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
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Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction

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Vascular changes in fetal growth restriction: clinical relevance and future therapeutics

Arvind Sehgal1,2, Padma Murthi3,4, Jane E Dahlstrom5

  • 1Monash Newborn, Monash Children's Hospital, Monash University, Melbourne, Australia. Arvind.Sehgal@monash.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association
|December 7, 2018
PubMed

Insights

Fetal growth restriction (FGR) leads to lasting arterial changes, linking in-utero issues to adult chronic diseases like hypertension and diabetes. Understanding these vascular adaptations is key for future therapies.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Cardiovascular Biology

Background:

  • Fetal growth restriction (FGR) impacts 5-10% of pregnancies, correlating with adverse perinatal outcomes and long-term chronic diseases like hypertension and diabetes.
  • Chronic hypoxemia from utero-placental insufficiency triggers cardiac and vascular adaptations in the fetus, which researchers are investigating at placental and molecular levels.
  • Persistent arterial abnormalities, including increased thickness and stiffness, are observed from fetal life into adulthood in FGR cohorts, suggesting a link to in-utero events.

Purpose of the Study:

  • To review current understanding of vascular maladaptive changes in fetal growth restriction (FGR).
  • To explore the role of these vascular changes in the development of chronic circulatory diseases.
  • To discuss the implications for investigating current and future therapeutic strategies for FGR.

Main Methods:

  • Utilizing findings from vascular ultrasound studies in fetal life through to young adulthood.
  • Analyzing data from the ex vivo dual perfusion model of the placenta to study placental hemodynamics in FGR.
  • Synthesizing microscopic and molecular-level investigations of placental changes in FGR.

Main Results:

  • Persistent arterial abnormalities (thickness, stiffness) are a hallmark in individuals affected by FGR.
  • These vascular changes appear to bridge the gap between in-utero placental insufficiency and adult chronic circulatory conditions.
  • The ex vivo dual perfusion model provides insights into placental hemodynamics relevant to FGR.

Conclusions:

  • Vascular maladaptive changes are a significant consequence of FGR, with lasting effects into adulthood.
  • These persistent arterial abnormalities represent a plausible link between fetal development and chronic disease risk.
  • Further research into these vascular changes is crucial for developing effective therapeutic interventions for FGR and its long-term sequelae.

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