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Fetal Circulation01:14

Fetal Circulation

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Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
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Transcutaneous Microcirculatory Imaging in Preterm Neonates
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Ocular blood flow in preterm neonates.

Ronald H Silverman1,2, Raksha Urs3, Jason D Horowitz3

  • 1Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY, USA. rs3072@cumc.columbia.edu.

Scientific Reports
|April 2, 2024
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Summary

Ultrafast Doppler ultrasound (PWU) can detect increased blood flow in preterm infants at risk for retinopathy of prematurity (ROP). This gentle, objective method aids in identifying ROP, potentially improving early diagnosis and treatment.

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Area of Science:

  • Ophthalmology
  • Neonatology
  • Medical Imaging

Background:

  • Retinopathy of prematurity (ROP) affects preterm neonates, potentially causing blindness.
  • Current diagnosis relies on subjective ophthalmoscopy, which can be stressful for infants.
  • Increased vascular endothelial growth factor (VEGF) in ROP suggests elevated ocular blood flow.

Purpose of the Study:

  • To evaluate ultrafast plane-wave Doppler ultrasound (PWU) for detecting increased ocular blood flow in ROP.
  • To assess PWU as a gentle, objective diagnostic tool for ROP risk identification.

Main Methods:

  • Fifty low-birthweight preterm neonates were imaged using 18 MHz PWU.
  • Flow velocities in the central retinal artery (CRA), central retinal vein (CRV), and short posterior ciliary arteries were measured.
  • Multivariate models incorporating clinical and Doppler parameters were compared for ROP staging.

Main Results:

  • Significantly increased CRA and CRV velocities were observed in Stage 3 ROP eyes.
  • Models using Doppler parameters (AUC=0.812) and combined clinical/Doppler parameters (AUC=0.904) outperformed clinical factors alone (AUC=0.760) in identifying Stage 3 ROP.

Conclusions:

  • PWU Doppler is a promising, gentle, and objective method for assessing ocular blood flow in neonates.
  • This technique can aid in identifying infants at risk for ROP, complementing existing ophthalmoscopy methods.