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Updated: Jun 13, 2025
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Maternal hemodynamics in early and late fetal growth restriction
Barbara Vasapollo1, Gian Paolo Novelli2, Daniele Farsetti1
1Department of Surgical Sciences, Tor Vergata University, Rome, Italy; Obstetrics and Gynecology, Policlinico Casilino Hospital, Rome, Italy.
Insights
Fetal growth restriction (FGR) is linked to maternal cardiovascular changes, detectable early. Identifying this hypovolemic, hypodynamic state may enable interventions for better newborn outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Cardiovascular Physiology
Background:
- Fetal growth restriction (FGR) presents early and late forms, impacting neonatal health and long-term development.
- FGR is associated with distinct maternal cardiovascular profiles detectable throughout pregnancy.
- Current understanding necessitates improved methods for early risk identification and management.
Purpose of the Study:
- To characterize the maternal cardiovascular profile in fetal growth restriction.
- To explore the utility of non-invasive cardiovascular assessments for early risk identification.
- To investigate the hemodynamic underpinnings of FGR for potential therapeutic targets.
Main Methods:
- Utilized echocardiography and other non-invasive cardiovascular monitoring devices.
- Analyzed maternal cardiovascular parameters across different stages of pregnancy.
- Correlated maternal hemodynamic profiles with FGR subtypes (early vs. late).
Main Results:
- Maternal cardiovascular alterations are present in both early and late FGR, differing in severity.
- A hypovolemic and hypodynamic maternal hemodynamic state characterizes FGR.
- Non-invasive methods effectively identify at-risk pregnancies.
Conclusions:
- Maternal cardiovascular profiling is crucial for understanding and managing FGR.
- Early identification of the specific maternal hemodynamic state can aid in risk stratification.
- Non-pharmacological and pharmacological interventions targeting the maternal cardiovascular profile show promise but require further research.
Abstract:
Fetal growth restriction is a challenging condition for the obstetricians associated to neonatal morbidity, unfavorable developmental outcomes, and long-term sequalae for the newborn. Guidelines divide this condition in two subtypes: early and late forms depending on biometric, Doppler parameters, and the gestational age at appearance (before or after 32 weeks gestation). This condition is associated to a maternal cardiovascular profile detectable in the pre-conceptional period, in the early stages of pregnancy, as well in the second and third trimester of pregnancy. The maternal cardiovascular alterations are similar in the two subtypes of fetal growth restriction, although they differ in the degree of expression. Echocardiography and other non invasive cardiovascular devices are very useful for the characterization of the maternal cardiovascular profile, and allow the early identification of patients at risk for this pathological condition. The particular maternal hemodynamic profile at the base of the development of fetal growth restriction is characterized by a hypovolemic hypodynamic state. This particular cardiovascular condition might be susceptible to be modified by promising non pharmacological and pharmacological interventions, although they need further clinical investigations to be routinely used.
