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Circulatory changes in fetuses with imminent asphyxia.

G Lingman, J Laurin, K Marsál

    Biology of the Neonate
    |January 1, 1986
    PubMed
    Summary
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    Fetal aortic blood flow changes, including absent diastolic flow, can predict imminent asphyxia days before cardiotocographic changes appear. This Doppler ultrasound finding offers a potential early warning sign for fetal distress.

    Area of Science:

    • Perinatal Medicine
    • Fetal Physiology
    • Diagnostic Ultrasound

    Background:

    • Cardiotocography (CTG) is standard for monitoring fetal well-being.
    • Identifying early indicators of fetal asphyxia is crucial for timely intervention.
    • Doppler ultrasound offers non-invasive assessment of fetal circulation.

    Purpose of the Study:

    • To investigate fetal blood flow velocity changes in the descending aorta and umbilical vein.
    • To determine if these changes precede cardiotocographic signs of imminent asphyxia.
    • To assess the potential of Doppler ultrasound as an early diagnostic tool for fetal distress.

    Main Methods:

    • Combined real-time and pulsed Doppler ultrasound (2 MHz) was used.
    • Blood flow was measured in the descending aorta and umbilical vein of 11 fetuses.

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  • Fetuses were undergoing emergency cesarean section due to CTG abnormalities indicating asphyxia.

    • Main Results:

    • All fetuses showed altered aortic blood flow waveforms, notably absent diastolic flow.
    • Some fetuses exhibited reversed diastolic flow or increased aortic pulsatility index.
    • Umbilical vein flow remained normal, but some showed pulsations.
    • Aortic flow changes preceded CTG changes by 1-3 days.

    Conclusions:

    • Altered fetal aortic diastolic blood flow is a sensitive indicator of impending asphyxia.
    • Doppler ultrasound assessment of fetal aortic flow may serve as an early warning sign.
    • This method could improve the timely detection and management of fetal distress.