o_1977r8vv9vk1ts2ms0kd8pksa.pdf

a Chapter 13 Cerebral and Umbilical Doppler in the Prediction of Fetal Outcome 195
ies, and (b) to point out the physiopathological phenomena
responsible for fetal flow disturbances. For
the latter aims, animal experimentation will be of
great interest.
Figure 13.17 shows the evolution of URI and CRI
in a pregnancy without evident complication but in
which the fetal weight at term was at the tenth centile;
however, the C/U ratio was at the limit of its normal
range, demonstrating that even in the absence of
any fetal or maternal clinical signs, the fetal circulation
can change with consequent alterations in the
oxygen and nutrient supply.
References
1. Cohn HE, Sacks EJ, Heymann MA, Rudolph AM (1974)
Cardiovascular responses to hypoxemia and acidemia
in fetal lambs. Am J Obstet Gynecol 120:817±824
2. Wladimiroff JW, van de Wijngaard JA, Degani S, Stewart
PA (1987) Cerebral and umbilical arterial blood
flow velocity waveform in normal and growth retarded
pregnancies. Obstet Gynecol 69:705±709
3. Arbeille P, Maulik D, Laurini R (eds) (1999) Fetal hypoxia.
Parthenon, London
4. Itskovitz J, LaGamma EF, Bristow J, Rudolph AM
(1991) Cardiovascular responses to hypoxemia in sinoaortic-denervated
fetal sheep. Pediatr Res 30:381±385
5. Fouron JC, Teyssier G, Maroto E, Lessart M, Marquette
G (1991) Diastolic circulatory dynamics in the presence
of elevated placental resistance and retrograde diastolic
flow in the umbilical artery: Doppler echographic study
in lambs. Am J Obstet Gynecol 164:195±203
6. Kjellmer I, Thordstein M, Wennergren M (1992) Cerebral
function in the growth-retarded fetus and neonate.
Biol Neonate 62:265±270
7. Arbeille Ph, Maulik D, Salihagic A, Locatelli A, Lansac
J, Platt LD (1997) Effect of long term cocaine administration
to pregnant ewes on the utero-placental flows,
fetal pO 2 , and growth. Obstet Gynecol 90:795±802
8. Arbeille P, Carles G, Tobal N, Herault S, Georgescus M,
Bousquet F, Perrotin F (2002) Fetal flow redistribution
to the brain in response to malaria infection. Does protection
of the fetus against malaria develops across
time. J Ultrasound Med 21:739±746
9. Laurini R, Arbeille B, Genberg C, Akoka S, Locatelli A,
Lansac J, Arbeille P (1999) Brain damage and hypoxia
in an ovine fetal chronic cocaine model. Eur J Obstet
Gynecol Reprod Biol 86:15±22
10. Salihagic A, Georgescus M, Perrotin F, Laurini R, Arbeille
B, Fignon A, Zudenogo D, Kurjak A, Arbeille P
(2000) Daily Doppler assessment of the fetal hemodynamic
response to chronic hypoxia: a five case report.
Prenat Neonat Med 5:35±41
11. Lindsay H (1997) Pregnancy and iron deficiency. Nutr
Rev 4:91±101
12. Steep P, Ash A, Wadsworth J, Welch A (1995) Relation
between material haemoglobin concentration and birth
weight in different ethnic group. Br Med J 310:489±491
13. Allen LH (2000) Anemia and iron deficiency effects on
pregnancy outcome. Am J Clin Nutr Suppl 71:1280±1284
14. Colomer J, Colomer C, Gutierrez D, Jubert A, Nolasco
A, Donat J, Fernandez-Delgado R, Donat F, Alvarez-
Dardet C (1990) Anaemia during pregnancy as a risk
factor for infant iron deficiency: report from the Valencia
Infant Anaemia Cohort (VIAC) study. Paediatr Perinat
Epidemiol 4:196±204
15. Ribbert LS, Snijders RJ, Nicolaides KH, Visser GH
(1991) Relation of fetal blood gases and data from
computer-assisted analysis of fetal heart rate patterns
in small for gestation fetuses. Br J Obstet Gynaecol 98:
820±823
16. Dawes GS, Moulden M, Redman CW (1996) Improvements
in computerized fetal heart rate analysis antepartum.
J Perinat Med 24:25±36
17. Lenstrup C, Haase N (1985) Predictive value of antepartum
fetal heart rate non-stress test in high risk
pregnancy. Acta Obstet Gynecol Scand 64:133±138
18. Weiner Z, Farmakides G, Schulman H, Lopresti S,
Schneider E (1996) Surveillance of growth-retarded fetuses
with computerized fetal heart rate monitoring
combined with Doppler velocimetry of the umbilical
and uterine arteries. J Reprod Med 41:112±118
19. Hecher K, Bilardo CM, Stigter RH, Ville Y, Hackeloer
BJ, Kok HJ, Senat MV, Visser GH (2001) Monitoring of
fetuses with intrauterine growth restriction: a longitudinal
study. Ultrasound Obstet Gynecol 18:564±570
20. Baschat A, Gembruch U, Harman CR (2001) The sequence
of changes in Doppler and biophysical parameters
as severe fetal growth restriction worsens. Ultrasound
Obstet Gynecol 18:571±577
21. Ferrazzi E, Bozzo M, Rigano S, Bellotti M, Morabito A,
Pardi G, Battaglia FC, Galan HL (2002) Temporal sequence
of abnormal Doppler changes in the peripheral
and central circulatory systems of the severely growthrestricted
fetus. Ultrasound Obstet Gynecol 19:140±146
22. Arbeille P, Tranquart F, Body G (1986) Evolution de la
circulation art rielle ombilicale et c r brale du foetus
au cours de la grossesse. Progr s en n onatologie. Karger
Edit 6:30±37
23. Arbeille P, Roncin A, Berson M (1987) Exploration of
the fetal cerebral blood flow by Doppler ultrasound in
normal and pathological pregnancies. Ultrasound Med
Biol 13:329±333
24. Woo JSK, Liang ST, Lo RLS, Chang FY (1987) Middle
cerebral artery Doppler flow velocity waveform. Obstet
Gynecol 70:613±616
25. Wladimiroff JW, Tonge HM, Stewart PA (1986) Doppler
ultrasound assessment of cerebral blood flow in the
human fetus. Br J Obstet Gynaecol 93:471±475
26. Arbeille P, Montenegro N, Tranquart F, Berson M
(1990) Assessment of the fetal cerebrovascular areas by
color coded Doppler. J Echocardiogr 7:629±634
27. Arbeille P, Berson M, Maulik D, Bodard S, Locatelli A
(1992) New implanted Doppler sensors for the assessment
of the main fetal hemodynamics. Ultrasound
Med Biol 18:97±103
28. Arbeille P, Bosc M, Vaillant M, Bodart S (1992) Nicotine-induced
changes in cerebral circulation in ovine
fetuses. Am J Perinatol 9:268±272
29. Adamson SL, Morrow RJ, Languille BL (1990) Side dependent
effects of increases in placental vascular resistance
on the umbilical arterial velocity waveform in fetal
sheep. Ultrasound Med Biol 6:19±27
30. Maulik D, Yarlagada P, Nathanielsz LP (1989) Hemodynamic
validation of Doppler assessment of fetoplacental